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General NPI Number Information
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NPI Number | 1104214618
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Entity Type | Organization
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Legal Business Name | PERMA MENTAL HEALTH PLLC
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Dates
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Enumeration Date | 01/06/2015
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 950 W BANNOCK ST STE 1100 STE. 1100
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City | BOISE
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State | ID
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Zip | 83702-6140
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Country | US
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Telephone | 208-996-1700
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Fax | 855-593-7090
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Provider Business Mailing Address
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Address Line | 950 W BANNOCK ST STE 1100 STE. 1100
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City | BOISE
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State | ID
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Zip | 83702-6140
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Country | US
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Telephone | 208-996-1700
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Fax | 855-593-7090
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | NATASHA ALLEN
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Credential |
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Telephone | 208-996-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD 12500
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License Number State | ID
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