NPI 1235947524

Open Space Mental Health LLC

Organisation Psychiatry Physician Idaho Falls, ID

Practice location

Address: 530 S Holmes Ave, Idaho Falls, ID 83401-5056
Phone: (307) 690-2938
Mailing address: PO Box 955, Wilson, WY 83014-0955

Authorised official

Name: Benjamin G Rae
Title: Owner
Phone: (307) 690-2938

Registered specialties

Psychiatry Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2084P0800X

Other Psychiatry & Neurology providers in Idaho →

Registry record

NPI: 1235947524
Entity type: Organization
NPI issued: 19 Dec 2024
Record last updated: 19 Dec 2024

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.