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General NPI Number Information
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NPI Number | 1174488746
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Entity Type | Organization
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Legal Business Name | BH-ID OPCO IF, LLC
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 383 ENERGY DR
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City | IDAHO FALLS
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State | ID
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Zip | 83401-4880
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Country | US
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Telephone | 986-202-8190
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 12125
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City | PORTLAND
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State | OR
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Zip | 97212-0125
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Country | US
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Telephone | 619-889-3399
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Fax |
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Authorized Official
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Title or Position | GENERAL COUNSEL
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Name | CHAD ENGBRECHT
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Credential |
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Telephone | 858-254-2510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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