Organization
MOUNTAIN VIEW BEHAVIORAL HEALTH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEME DELLAIRO LCSW (DIRECTOR)
(208) 322-5354
Entity
Organization
Contact information
Practice address
5593 N GLENWOOD ST, BOISE, ID 83714-1336
(208) 322-5354
(203) 322-5379
Mailing address
5593 N GLENWOOD ST, BOISE, ID 83714-1336
(208) 322-5354
(203) 322-5379
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
LCSW24873
ID
251S00000X
Community/Behavioral Health Agency
Primary
M7882
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154477321
—
ID
Enumeration date
02/02/2012
Last updated
05/12/2016
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