Provider Demographics
NPI:1982366670
Name:WEST WIND MENTAL HEALTH
Entity Type:Organization
Organization Name:WEST WIND MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TENNANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-572-2883
Mailing Address - Street 1:820 S LATAH ST STE 106
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-2255
Mailing Address - Country:US
Mailing Address - Phone:208-572-2883
Mailing Address - Fax:
Practice Address - Street 1:820 S LATAH ST STE 106
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-2255
Practice Address - Country:US
Practice Address - Phone:208-572-2883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-10
Last Update Date:2021-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty