Provider Demographics
NPI:1154441319
Name:V & T MENTAL HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:V & T MENTAL HEALTH SERVICES, INC
Other - Org Name:DAYBREAK MENTAL WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KADE
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-463-7719
Mailing Address - Street 1:3307 CALDWELL BLVD
Mailing Address - Street 2:STE # 104
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-6402
Mailing Address - Country:US
Mailing Address - Phone:208-463-7719
Mailing Address - Fax:208-463-7750
Practice Address - Street 1:3307 CALDWELL BLVD
Practice Address - Street 2:STE # 104
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-6402
Practice Address - Country:US
Practice Address - Phone:208-463-7719
Practice Address - Fax:208-463-7750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID0025610Medicaid
ID8073533Medicaid
ID8053055Medicaid
ID8073808Medicaid
ID8040505Medicaid