=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093664930
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FOUNDRY BEHAVIORAL HEALTH PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/23/2026
-----------------------------------------------------
Last Update Date | 01/23/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 950 W BANNOCK ST STE NO1100
-----------------------------------------------------
City | BOISE
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83702-5999
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-682-8784
-----------------------------------------------------
Fax | 208-689-6993
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 784 S CLEARWATER LOOP STE B
-----------------------------------------------------
City | POST FALLS
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83854-9599
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-682-8784
-----------------------------------------------------
Fax | 208-689-6993
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ORION C WEINZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 208-682-8784
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------