# AVID MENTAL HEALTH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174387088
- **Authorized official:** JESSICA JUN PMHNP (COO)
- **Authorized official phone:** (623) 298-5044

## Contact information

- **Practice address:** 100 N HOWARD ST STE R, SPOKANE, WA 99201-0508
- **Practice address phone:** (623) 298-5044
- **Mailing address:** 640 S SUNSET AVE STE 102, WEST COVINA, CA 91790-2808

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 02/12/2024
- **Last updated:** 03/27/2024