Healthcare Provider Details

I. General information

NPI: 1215469440
Provider Name (Legal Business Name): MENTAL HEALTH SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 03/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3152 S BOWN WAY STE 102
BOISE ID
83706-5456
US

IV. Provider business mailing address

3060 S ROOKERY LN
BOISE ID
83706-5484
US

V. Phone/Fax

Practice location:
  • Phone: 208-371-8040
  • Fax: 866-371-6410
Mailing address:
  • Phone: 208-371-8040
  • Fax: 866-371-6410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberCNS-65-A
License Number StateID

VIII. Authorized Official

Name: SATU HANNELE WOODLAND
Title or Position: CLINICAL DIRECTOR
Credential: APRN-BC, PMHCNS
Phone: 208-371-8040