Organization
ALLIED MENTAL HEALTH SERVICES, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CORY L. THACKER M.S. (PRESIDENT/OWNER)
(208) 286-7967
Entity
Organization
Contact information
Practice address
11104 W. STATE ST., STAR, ID 83669
(208) 286-7967
(208) 286-9047
Mailing address
PO BOX 545, STAR, ID 83669-0545
(208) 286-7967
(208) 286-9047
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/11/2007
Last updated
09/11/2007
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