Provider Demographics
NPI:1679791479
Name:RELIANCE MENTAL HEALTH
Entity type:Organization
Organization Name:RELIANCE MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFIC MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PARRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-525-8339
Mailing Address - Street 1:447 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83402-3608
Mailing Address - Country:US
Mailing Address - Phone:208-525-8339
Mailing Address - Fax:208-535-8339
Practice Address - Street 1:447 PARK AVE
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83402-3608
Practice Address - Country:US
Practice Address - Phone:208-525-8339
Practice Address - Fax:208-535-8339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management