| Mountain Home Behavioral Health Llc | |
|
1815 American Legion Blvd Ste A Mountain Home ID 83647-3166 | |
| (208) 409-7122 | |
| Not Available |
| Full Name | Mountain Home Behavioral Health Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1815 American Legion Blvd Ste A, Mountain Home, Idaho |
| Authorized Official Name and Position | Reysan R Cotton (OWNER) |
| Authorized Official Contact | 2084097122 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Home Behavioral Health Llc 1225 E 18th N Mountain Home ID 83647-1822 Ph: (208) 409-7122 | Mountain Home Behavioral Health Llc 1815 American Legion Blvd Ste A Mountain Home ID 83647-3166 Ph: (208) 409-7122 |
| NPI Number | 1932856135 |
|---|---|
| Provider Enumeration Date | 03/07/2022 |
| Last Update Date | 03/11/2022 |
| Certification Date | 03/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932856135 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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