| Mountain View Behavioral Health, Pllc | |
|
5593 N Glenwood St Boise ID 83714-1336 | |
| (208) 322-5354 | |
| (203) 322-5379 |
| Full Name | Mountain View Behavioral Health, Pllc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5593 N Glenwood St, Boise, Idaho |
| Authorized Official Name and Position | Deme Dellairo (DIRECTOR) |
| Authorized Official Contact | 2083225354 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain View Behavioral Health, Pllc 5593 N Glenwood St Boise ID 83714-1336 Ph: (208) 322-5354 | Mountain View Behavioral Health, Pllc 5593 N Glenwood St Boise ID 83714-1336 Ph: (208) 322-5354 |
| NPI Number | 1124390406 |
|---|---|
| Provider Enumeration Date | 02/02/2012 |
| Last Update Date | 05/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124390406 | NPI | - | NPPES |
| 1154477321 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LCSW24873 (Idaho) | Secondary |
| 251S00000X | Community/behavioral Health | M7882 (Idaho) | Primary |
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