Healthcare Provider Details

I. General information

NPI: 1962018564
Provider Name (Legal Business Name): ACCESS BEHAVIORAL HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2020
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1276 W RIVER ST
BOISE ID
83702-7066
US

IV. Provider business mailing address

1276 W RIVER ST
BOISE ID
83702-7066
US

V. Phone/Fax

Practice location:
  • Phone: 208-338-4699
  • Fax: 208-322-4722
Mailing address:
  • Phone: 208-338-4699
  • Fax: 208-322-4722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: NICCOLIA L TANGEN
Title or Position: OWNER
Credential:
Phone: 208-338-4699