LATINO STAND UP IDAHO LLC NPI 1649539495

NPI Information

NPI: 1649539495
Provider Name: LATINO STAND UP IDAHO LLC

Doing Business As: LATINO STAND UP LLC

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
1680 WOODRUFF PARK
SUITE A
IDAHO FALLS, ID
ZIP 83401
Phone: (208) 346-2222
Get Directions

LATINO STAND UP IDAHO LLC is a mental health (including community mental health center) clinic center in Idaho Falls, ID. LATINO STAND UP IDAHO LLC NPI is 1649539495. The provider is registered as an organization entity type.
The provider Is Doing Business As Latino Stand Up Llc.

The provider's business location address is:

1680 WOODRUFF PARK
SUITE A
IDAHO FALLS, ID
ZIP 83401-330
Phone: (208) 346-2222

The provider's authorized official is Roger T Horne .
The authorized official title is Owner and has the following contact phone number (208) 346-2222.

The enumeration date for this NPI number is 5/15/2012 and was last updated on 5/20/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	251B00000X	Case Management			No
2	251S00000X	Community/Behavioral Health			No
3	261QM0850X	Clinic/Center	Adult Mental Health		No
4	261QM0855X	Clinic/Center	Adolescent and Children Mental Health		No
5	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder		No
6	163W00000X	Registered Nurse		IDAHO	No
7	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	IDAHO	No
8	363AM0700X	Physician Assistant	Medical	IDAHO	No
9	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)		Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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