# IDAHO PSYCHIATRIC INSTITUTE

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

## Provider details

- **NPI number:** 1285959908
- **Authorized official:** SHAWN THURBER PH.D., LMFT (PRESIDENT)
- **Authorized official phone:** (208) 529-4300

## Contact information

- **Practice address:** 1975 MARTHA AVE, IDAHO FALLS, ID 83404-7580
- **Practice address phone:** (208) 529-4300
- **Practice address fax:** (208) 529-1627
- **Mailing address:** 1975 MARTHA AVE, IDAHO FALLS, ID 83404-7580
- **Mailing address phone:** (208) 529-4300
- **Mailing address fax:** (208) 529-1627

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | OT965 | ID | Yes |

## Other

- **Enumeration date:** 04/06/2010
- **Last updated:** 04/06/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 808091300 | — | ID |
| 05 | — | 808091400 | — | ID |