NPI 1023221504

Behavioral Reform INC

Organisation Community/Behavioral Health Agency Pocatello, ID

Practice location

Address: 1135 Yellowstone Ave STE D, Pocatello, ID 83201-4371
Phone: (208) 238-9400
Fax: (208) 238-9401
Mailing address: 310 N Shilling Ave, Blackfoot, ID 83221-2334

Authorised official

Name: Gary O Horton
Title: Owner
Phone: (208) 782-0376

Registered specialties

Community/Behavioral Health Agency Primary

Agencies Taxonomy 251S00000X Licence PSY-164 (ID)

Other Community/Behavioral Health providers in Idaho →

Registry record

NPI: 1023221504
Entity type: Organization
NPI issued: 8 May 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.