Organization
BEHAVIORAL REFORM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY O HORTON PH.D, LP, LCPC, NCC (OWNER)
(208) 782-0376
Entity
Organization
Contact information
Practice address
1135 YELLOWSTONE AVE STE D, POCATELLO, ID 83201-4371
(208) 238-9400
(208) 238-9401
Mailing address
310 N SHILLING AVE, BLACKFOOT, ID 83221-2334
(208) 782-0376
(208) 782-9612
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
PSY-164
ID
Other
Enumeration date
05/08/2007
Last updated
08/22/2020
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