Provider Demographics
NPI:1417120304
Name:ASSURANCE BEHAVIORAL HEALTH, LLC.
Entity Type:Organization
Organization Name:ASSURANCE BEHAVIORAL HEALTH, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:FRIES
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:208-392-4356
Mailing Address - Street 1:12 HIGH MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83716-2946
Mailing Address - Country:US
Mailing Address - Phone:208-392-4356
Mailing Address - Fax:
Practice Address - Street 1:3852 HIGHWAY 21
Practice Address - Street 2:
Practice Address - City:IDAHO CITY
Practice Address - State:ID
Practice Address - Zip Code:83631
Practice Address - Country:US
Practice Address - Phone:208-629-6523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management