Healthcare Provider Details

I. General information

NPI: 1457266181
Provider Name (Legal Business Name): RURAL MOUNTAIN HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

690 N 2ND E STE 103
MOUNTAIN HOME ID
83647-1339
US

IV. Provider business mailing address

690 N 2ND E STE 103
MOUNTAIN HOME ID
83647-1339
US

V. Phone/Fax

Practice location:
  • Phone: 986-284-0039
  • Fax:
Mailing address:
  • Phone: 986-284-0039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MR. BRION PRINCE BETHEL SR.
Title or Position: CEO
Credential:
Phone: 208-869-2744