| NPI | 1588199277 |
|---|---|
| Doing Business As | PRIDE MENTAL HEALTH |
| Entity Type | Organization |
| Authorized Contact | DANE M. MULLEN Owner/Operator 208-322-2928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 261Q00000X Clinic/Center | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2024-09-18 |