Organization
SNAKE RIVER MENTAL HEALTH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GORDON BRADLEY GREAVES PA (OWNER)
(801) 664-1757
Entity
Organization
Contact information
Practice address
15821 ALLENDALE RD, WILDER, ID 83676-5864
(208) 278-2863
(208) 621-3128
Mailing address
15821 ALLENDALE RD, WILDER, ID 83676-5864
(208) 278-2863
(208) 621-3128
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
01/08/2025
Last updated
04/14/2025
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