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General NPI Number Information
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NPI Number | 1447305610
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Entity Type | Organization
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Legal Business Name | DIRNE HEALTH CENTERS, INC
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 1090 WEST PARK PLACE SUITE B
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City | COEUR D ALENE
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State | ID
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Zip | 83814
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Country | US
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Telephone | 208-292-0303
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Fax | 208-664-5346
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Provider Business Mailing Address
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Address Line | PO BOX 1387
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City | HAYDEN
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State | ID
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Zip | 83835-1387
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Country | US
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Telephone | 208-620-5200
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MIKE BAKER
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Credential |
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Telephone | 208-620-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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