Healthcare Provider Details

I. General information

NPI: 1922582501
Provider Name (Legal Business Name): INTEGRITY PSYCHIATRIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2018
Last Update Date: 02/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5440 W FRANKLIN RD STE 108
BOISE ID
83705-6433
US

IV. Provider business mailing address

5440 W FRANKLIN RD STE 108
BOISE ID
83705-6433
US

V. Phone/Fax

Practice location:
  • Phone: 208-283-7714
  • Fax:
Mailing address:
  • Phone: 208-283-7314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CAREY DAWN CRILL
Title or Position: OWNER
Credential: ARNP
Phone: 208-283-7314