MEDICARE: HONOR BEHAVIORAL HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1629934872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HONOR BEHAVIORAL HEALTH LLC

Provider Business Mailing Address
First Line	:	7091 W EMERALD ST
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83704-8618
Country	:	US
Telephone Number	:	208-423-0002
Fax Number	:

Provider Business Practice Location Address
First Line	:	7091 W EMERALD ST
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83704-8618
Country	:	US
Telephone Number	:	208-423-0002
Fax Number	:

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	MR. PETER EDWARD GIFFORD II
Credential	:
Telephone Number	:	602-816-9421

Provider Enumeration Date	:	12/31/2025
Last Update Date	:	12/31/2025

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