Organization
INTEGRATED INTERVENTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY LEE EDELMANN (OWNER)
(208) 651-0095
Entity
Organization
Contact information
Practice address
2482 E. GLACIER RD., HAYDEN LAKE, ID 83835
(208) 651-0095
Mailing address
2482 E. GLACIER RD., HAYDEN LAKE, ID 83835
(208) 651-0095
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
09/23/2013
Last updated
09/23/2013
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