Provider Demographics
NPI:1689236648
Name:RAHMANA ELIZABETH SAYRE
Entity Type:Organization
Organization Name:RAHMANA ELIZABETH SAYRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:D
Authorized Official - Last Name:SAYRE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-696-1645
Mailing Address - Street 1:5032 W WOLFE ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-1174
Mailing Address - Country:US
Mailing Address - Phone:208-696-1645
Mailing Address - Fax:
Practice Address - Street 1:750 E WARM SPRINGS AVE STE D1
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83712-6457
Practice Address - Country:US
Practice Address - Phone:208-696-1645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-30
Last Update Date:2019-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)