| Behavioral Reform Inc | |
|
1135 Yellowstone Ave Ste D Pocatello ID 83201-4371 | |
| (208) 238-9400 | |
| (208) 238-9401 |
| Full Name | Behavioral Reform Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1135 Yellowstone Ave Ste D, Pocatello, Idaho |
| Authorized Official Name and Position | Gary O Horton (OWNER) |
| Authorized Official Contact | 2087820376 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Reform Inc 310 N Shilling Ave Blackfoot ID 83221-2334 Ph: (208) 782-0376 | Behavioral Reform Inc 1135 Yellowstone Ave Ste D Pocatello ID 83201-4371 Ph: (208) 238-9400 |
| NPI Number | 1023221504 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023221504 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | PSY-164 (Idaho) | Primary |
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