Healthcare Provider Details

I. General information

NPI: 1134096324
Provider Name (Legal Business Name): RHEMA MANNING
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 E MAGIC VIEW DR
MERIDIAN ID
83642-3154
US

IV. Provider business mailing address

2950 E MAGIC VIEW DR
MERIDIAN ID
83642-3154
US

V. Phone/Fax

Practice location:
  • Phone: 208-600-2184
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: