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Organization
EAST IDAHO MENTAL HEALTH LLC
Active
Organization
EAST IDAHO MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESTIN THAYNE (ADMINISTRATOR)
(208) 359-2101
Entity
Organization
Contact information
Practice address
859 S YELLOWSTONE HWY STE 3201, REXBURG, ID 83440-6200
(208) 359-2101
Mailing address
859 S YELLOWSTONE HWY STE 3201, REXBURG, ID 83440-6200
(208) 359-2101
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/30/2024
Last updated
06/03/2025
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