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General NPI Number Information
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NPI Number | 1891414173
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Entity Type | Organization
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Legal Business Name | TREASURE VALLEY MENTAL HEALTH
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Dates
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Enumeration Date | 08/22/2022
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 6126 W STATE ST STE 402
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City | BOISE
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State | ID
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Zip | 83703-2741
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Country | US
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Telephone | 208-479-1116
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Fax |
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Provider Business Mailing Address
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Address Line | 6126 W STATE ST STE 402
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City | BOISE
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State | ID
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Zip | 83703-2741
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Country | US
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Telephone | 208-479-1116
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOE L. ARZOLA
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Credential | L.M.S.W.
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Telephone | 208-479-1116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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