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General NPI Number Information
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NPI Number | 1831915198
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Entity Type | Organization
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Legal Business Name | FAMILY FOCUS MENTAL HEALTH LLC
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 845 W CENTER ST STE 116
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City | POCATELLO
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State | ID
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Zip | 83204-4237
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Country | US
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Telephone | 208-794-4593
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Fax |
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Provider Business Mailing Address
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Address Line | 2461 SHAYLA PL
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City | POCATELLO
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State | ID
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Zip | 83201-7016
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EARL WESTON
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Credential | DNP
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Telephone | 208-648-3135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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