| Integrated Health Solutions, Llc | |
|
10022 W Dylan Ct Star ID 83669-5643 | |
| (208) 571-2723 | |
| Not Available |
| Full Name | Integrated Health Solutions, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10022 W Dylan Ct, Star, Idaho |
| Authorized Official Name and Position | Brian Lynn Raymond (OWNER/CLINICIAN) |
| Authorized Official Contact | 2085712723 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Health Solutions, Llc 10022 W Dylan Ct Star ID 83669-5643 Ph: (208) 571-2723 | Integrated Health Solutions, Llc 10022 W Dylan Ct Star ID 83669-5643 Ph: (208) 571-2723 |
| NPI Number | 1437917390 |
|---|---|
| Provider Enumeration Date | 03/06/2024 |
| Last Update Date | 03/06/2024 |
| Certification Date | 03/06/2024 |
| Medicare PECOS PAC ID | 2668812819 |
|---|---|
| Medicare Enrollment ID | O20240503003377 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437917390 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Brian L Raymond |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043468903 PECOS PAC ID: 3274689690 Enrollment ID: I20090925000252 |
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