| Incline Mental Health Pllc | |
|
413 N Allumbaugh St Ste 101 Boise ID 83704-9219 | |
| (208) 323-1125 | |
| Not Available |
| Full Name | Incline Mental Health Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 413 N Allumbaugh St Ste 101, Boise, Idaho |
| Authorized Official Name and Position | Aaron J Crum (OWNER) |
| Authorized Official Contact | 7204743076 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Incline Mental Health Pllc 413 N Allumbaugh St Ste 101 Boise ID 83704-9219 Ph: (208) 323-1125 | Incline Mental Health Pllc 413 N Allumbaugh St Ste 101 Boise ID 83704-9219 Ph: (208) 323-1125 |
| NPI Number | 1598391278 |
|---|---|
| Provider Enumeration Date | 03/13/2020 |
| Last Update Date | 04/21/2021 |
| Certification Date | 04/21/2021 |
| Medicare PECOS PAC ID | 3072944784 |
|---|---|
| Medicare Enrollment ID | O20200513002470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598391278 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Aaron J Crum |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588000996 PECOS PAC ID: 1658662952 Enrollment ID: I20181102001904 |
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