Organization
LIGHTHOUSE BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAZIN IBRAHEEM (OWNER)
(208) 713-2311
Entity
Organization
Contact information
Practice address
6109 W OVERLAND RD # 101, BOISE, ID 83709-3018
(208) 713-2311
Mailing address
6109 W OVERLAND RD # 101, BOISE, ID 83709-3018
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/08/2025
Last updated
04/08/2025
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