SEQUEL TSI OF IDAHO LLC NPI 1740532118

NPI Information

NPI: 1740532118
Provider Name: SEQUEL TSI OF IDAHO, LLC

Doing Business As: MOUNTAIN HOME

Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
2850 INDUSTRIAL WAY
MOUNTAIN HOME, ID
ZIP 83647
Phone: (208) 587-2679
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SEQUEL TSI OF IDAHO, LLC is an adult mental health clinic center in Mountain Home, ID. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. SEQUEL TSI OF IDAHO, LLC NPI is 1740532118. The provider is registered as an organization entity type.
The provider Is Doing Business As Mountain Home.

The provider's business location address is:

2850 INDUSTRIAL WAY
MOUNTAIN HOME, ID
ZIP 83647-960
Phone: (208) 587-2679

The provider's authorized official is Chris Banken .
The authorized official title is Sr. Vice President Of Operations and has the following contact phone number (602) 335-2095.

The enumeration date for this NPI number is 10/10/2012 and was last updated on 10/10/2012.

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 Number	License State	Primary
1	261QM0850X	Clinic/Center	Adult Mental Health			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: 11/14/2023

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