Organization · NPI-2

Advanced Mental Health And Neurofeedback

Clinic/Center, Mental Health (Including Community Mental Health Center) · Idaho Falls, ID

NPI number1083326219
StatusActive
Last updated in NPPESDec 19, 2022

Details

NPI
1083326219
Entity type
Organization (NPI-2)
Legal business name
Advanced Mental Health And Neurofeedback
Organization subpart
No
Enumeration date
Dec 19, 2022
Certification date
Dec 19, 2022
Last updated
Dec 19, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes
101YM0800X Counselor, Mental Health––

Other names

  • Advanced Mental Health And Neurofeedback (Former Legal Business Name)

Practice location

2001 S Woodruff Ave Ste 11
Idaho Falls, ID 83404-6372

Phone 208-705-6771

Mailing address

631 Mark Ave
Idaho Falls, ID 83401-3116

Phone 208-705-6771

Authorized official

Connie Hobbs
Member
2087056771

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