# TELEMENTAL HEALTH LINK LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PSYCHIATRIC NURSE PRACTITIONER SERVICES LLC
- **Other names:** Psychiatric Nurse Practitioner Services LLC, TELEMENTAL HEALTH LINK - NM
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1437783529
- **Legal business name:** PSYCHIATRIC NURSE PRACTITIONER SERVICES LLC
- **Authorized official:** SUSAN M DERIVAS PMHNP-BC (AO)
- **Authorized official phone:** (208) 775-7418

## Contact information

- **Practice address:** 4055 E BLUEBERRY ST, MERIDIAN, ID 83642-8261
- **Practice address phone:** (208) 775-7418
- **Practice address fax:** (208) 647-5008
- **Mailing address:** 4055 E BLUEBERRY ST, MERIDIAN, ID 83642-8261
- **Mailing address phone:** (208) 600-2060
- **Mailing address fax:** (208) 647-5008

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 02/27/2020
- **Last updated:** 02/07/2024