Provider Demographics
NPI:1154095545
Name:D, G, AND S BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:D, G, AND S BEHAVIORAL HEALTH LLC
Other - Org Name:ABOUT BALANCE MENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KARL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:TIFFANY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-342-6300
Mailing Address - Street 1:6550 W EMERALD ST STE 112
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8780
Mailing Address - Country:US
Mailing Address - Phone:208-342-6300
Mailing Address - Fax:
Practice Address - Street 1:6550 W EMERALD ST STE 112
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8780
Practice Address - Country:US
Practice Address - Phone:208-342-6300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:D, G, AND S BEHAVIORAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty