Organization
SEQUEL TSI OF IDAHO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAULA GARAY M.A., LMFT (EXECUTIVE DIRECTOR)
(208) 587-2679
Entity
Organization
Contact information
Practice address
2850 INDUSTRIAL WAY, MOUNTAIN HOME, ID 83647-3960
(208) 587-2679
(208) 587-2875
Mailing address
2850 INDUSTRIAL WAY, MOUNTAIN HOME, ID 83647-3960
(208) 587-2679
(208) 587-2875
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/27/2012
Last updated
09/27/2012
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