Organization
ABHS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD J JOHANNSEN (ADMINISTRATOR)
(208) 455-1222
Entity
Organization
Contact information
Practice address
524 CLEVELAND BLVD, 230, CALDWELL, ID 83605-4076
(205) 455-1222
Mailing address
524 CLEVELAND BLVD, 230, CALDWELL, ID 83605-4076
(205) 455-1222
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
152380008
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152380008
—
ID
Enumeration date
08/26/2015
Last updated
08/26/2015
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