Idahodhwbh3 Payette Amh Psr

NPI #1568590073 in Payette, Idaho

Provider Information

NPI Number: 1568590073
Entity Type: Organization
Organization Name: Idahodhwbh3 Payette Amh Psr
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Feb 28, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 515 16TH AVE N
City: Payette
State: Idaho
ZIP Code: 83661-2047
Phone: (208) 642-6416

Authorized Official

Name: MR. TODD L HURT, M.S.
Title: FIELD OPERATIONS MANAGER
Phone: (208) 455-7057

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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