| Sequel Tsi Of Idaho | |
|
2850 Industrial Way Mountain Home ID 83647-3960 | |
| (208) 587-2679 | |
| (208) 587-2875 |
| Full Name | Sequel Tsi Of Idaho |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2850 Industrial Way, Mountain Home, Idaho |
| Authorized Official Name and Position | Paula Garay (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2085872679 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sequel Tsi Of Idaho 2850 Industrial Way Mountain Home ID 83647-3960 Ph: (208) 587-2679 | Sequel Tsi Of Idaho 2850 Industrial Way Mountain Home ID 83647-3960 Ph: (208) 587-2679 |
| NPI Number | 1528319704 |
|---|---|
| Provider Enumeration Date | 09/27/2012 |
| Last Update Date | 09/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528319704 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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