National Provider Identifier Database

HEALTHY MIND BEHAVIORAL HEALTH CLINIC LLC
Psychiatric/Mental Health, Child & Family


Contact Information

HEALTHY MIND BEHAVIORAL HEALTH CLINIC LLC
9492 W FAIRVIEW AVE
BOISE, ID83704-8101
Phone: 208-284-7100
Fax: 208-213-3659
Website:
Specialty Taxonomy Code
* Psychiatric/Mental Health, Child & Family 364SP0810X

* Indicates primary specialty

NPI Profile & details for HEALTHY MIND BEHAVIORAL HEALTH CLINIC LLC

NPI Number 1710766159
Legal business name
LBN
HEALTHY MIND BEHAVIORAL HEALTH CLINIC LLC
Authorized official CHRISTOPHER GAKWA - (PMHNP)
Entity Organization
Organization subpart No
Enumeration date 09/25/2023
Last updated 09/04/2024 - More than a year ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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