Organization
T HELP
Active
Other names
Sanctuary NTC
Organization subpart
No
Provider details
NPI number
Authorized official
TYRONE SHUMAN LCSW (OWNER)
(208) 417-0623
Entity
Organization
Contact information
Practice address
4737 S AFTON PL, SUITE A, CHUBBUCK, ID 83202-2317
(208) 417-0623
(208) 417-0641
Mailing address
PO BOX 2431, POCATELLO, ID 83206-2431
(208) 417-0623
(208) 417-0641
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
09/27/2013
Last updated
11/17/2025
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