Latino Stand Up Idaho LLC
NPI #1043556608 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1043556608
- Entity Type
- Organization
- Organization Name
- Latino Stand Up Idaho LLC
- Primary Specialty
- Clinic/Center - Mental Health (Including Community Mental Health Center)
- Enumeration Date
- Dec 28, 2012
- Last Updated
- May 23, 2013
Practice Location
- Address
- 1680 WOODRUFF PARK
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83401-3330
- Phone
- (208) 552-6373
Authorized Official
- Name
- MR. ROGER HORNE
- Title
- OWNER
- Phone
- (910) 573-0861
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Adult Mental Health — Adult Mental Health |
| Community/Behavioral Health |
| Psychiatry & Neurology - Child & Adolescent Psychiatry — Child & Adolescent Psychiatry |
| Physician Assistant - Medical — Medical |
| Clinical Nurse Specialist |
| Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder |
| Case Management |
| Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center) |
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