Blackfoot Behavioral Health, Llc

NPI 1003113465 - Psychiatric Residential Treatment Facility - 323P00000X

NPI Details
NPI 1003113465
Enumeration Date 02/22/2011
Last Updated 02/22/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name SANDEE SANDEE
Position ADMINISTRATOR
Phone (208) 782-1322
Fax (208) 782-1074
Practice Location
75 LILAC ST
BLACKFOOT ID, 83221-1768, US
Phone (208) 782-1322
Fax (208) 782-1074
Business Location
75 LILAC ST
BLACKFOOT ID, 83221-1768, US
Phone (208) 782-1322
Fax (208) 782-1074
Toxanomy
Taxonomy Code 323P00000X
License State Idaho
License Number LCSW26332
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According to our database, Blackfoot Behavioral Health, Llc NPI is 1003113465, taxonomy code is 323P00000X and license number is LCSW26332, license state is located at Idaho. Blackfoot Behavioral Health, Llc physically located at 75 Lilac St, Blackfoot ID, 83221-1768. NPI Number 1033115704 has the healthcare provider type.

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1003113465 NPI number is provided on an as is basis without warranty of any kind. 1003113465 is maintained by the National Plan & Provider Enumeration System. The contents of Blackfoot Behavioral Health, Llc are for informational purposes only.