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General NPI Number Information
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NPI Number | 1922607704
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Entity Type | Organization
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Legal Business Name | MAYS HEALING
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Dates
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Enumeration Date | 10/22/2020
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Last Update Date | 10/22/2020
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Provider Practice Location Address
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Address Line | 1024 E AMITY AVE
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City | NAMPA
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State | ID
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Zip | 83686-5502
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Country | US
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Telephone | 208-284-6243
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Fax | 208-475-7224
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Provider Business Mailing Address
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Address Line | 1024 E AMITY AVE
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City | NAMPA
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State | ID
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Zip | 83686-5502
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Country | US
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Telephone | 208-284-6243
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Fax | 208-475-7224
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Authorized Official
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Title or Position | OWNER
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Name | DUSTIN MAYS
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Credential | LCSW
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Telephone | 208-284-6243
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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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