Organization
BEHAVIORAL TREATMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI MUGERL (OWNER)
(208) 234-2600
Entity
Organization
Contact information
Practice address
210 E CENTER ST STE B, POCATELLO, ID 83201-6326
(208) 234-2600
Mailing address
210 E CENTER ST STE B, POCATELLO, ID 83201-6326
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952423519
—
ID
Enumeration date
01/14/2009
Last updated
01/14/2009
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