Organization
LIFESTANCE MENTAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN MPOYO (OWNER)
(208) 409-3978
Entity
Organization
Contact information
Practice address
17340 N WINGTIP WAY, NAMPA, ID 83687-4832
(208) 409-3978
Mailing address
17340 N WINGTIP WAY, NAMPA, ID 83687-4832
(208) 409-3978
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/05/2026
Last updated
01/05/2026
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