| NPI | 1700530979 |
|---|---|
| Former Legal Business Name | VIVANT BEHAVIORAL HEALTHCARE, LLC |
| Entity Type | Organization |
| Authorized Contact | SHANNON BURRESS Clinical Director 208-340-7855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2022-02-07 |
| Last Update Date | 2022-02-07 |