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Organization

EAST IDAHO MENTAL HEALTH LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DESTIN THAYNE (ADMINISTRATOR)
(208) 359-2101
Entity
Organization

Contact information

Practice address
859 S YELLOWSTONE HWY STE 3201, REXBURG, ID 83440-6200
(208) 359-2101
Mailing address
859 S YELLOWSTONE HWY STE 3201, REXBURG, ID 83440-6200
(208) 359-2101

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
04/30/2024
Last updated
06/03/2025
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