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General NPI Number Information
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NPI Number | 1700394822
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Entity Type | Organization
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Legal Business Name | LOOKOUT BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 01/11/2018
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 454 W LACEY AVE
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City | HAYDEN
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State | ID
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Zip | 83835-9735
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Country | US
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Telephone | 208-762-2500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2792
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City | HAYDEN
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State | ID
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Zip | 83835-2792
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Country | US
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Telephone | 208-704-0380
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GRAHAM CHRISTENSEN
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Credential |
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Telephone | 208-704-0380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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