OrganizationActive
Ambitions of Idaho, Inc
NPI 1003145533 · Mental Health Clinic/Center (Including Community Mental Health Center) · Coeur D Alene, ID
Provider details
- NPI number
- 1003145533
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Authorized official
- Shane Hagel, President
Practice location
1044 Northwest Blvd Ste C
Coeur D Alene, ID 83814-2114
Phone: (208) 930-1740
Fax: (208) 930-1695
Mailing address
1044 Northwest Blvd Ste C
Coeur D Alene, ID 83814-2114
Registry dates
- Enumerated
- 2009-12-11
- Last updated
- 2023-10-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.