Organization
NEW HORIZONS MENTAL WELLNESS CLINICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRIN ROBERTSON PMHNP-BC (OWNER)
(208) 233-2025
Entity
Organization
Contact information
Practice address
1352 E CENTER ST, SUITE A, POCATELLO, ID 83201-4734
(208) 233-2025
(208) 233-2178
Mailing address
1352 E CENTER ST, SUITE A, POCATELLO, ID 83201-4734
(208) 233-2025
(208) 233-2178
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
NP1034A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750621116
—
ID
Enumeration date
04/03/2015
Last updated
04/03/2015
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