Provider Demographics
NPI:1659991495
Name:MVHC PLLC
Entity Type:Organization
Organization Name:MVHC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:GILLIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-888-5848
Mailing Address - Street 1:2321 E GALA ST STE 3
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-7692
Mailing Address - Country:US
Mailing Address - Phone:208-888-5848
Mailing Address - Fax:208-888-0884
Practice Address - Street 1:303 N ALLUMBAUGH ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-9208
Practice Address - Country:US
Practice Address - Phone:208-888-5848
Practice Address - Fax:208-888-0884
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIDVALLEY HEALTHCARE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-22
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty