OrganizationActive
Sequel Tsi of Idaho, LLC
NPI 1073843868 · Emotionally Disturbed Childrens' Residential Treatment Facility · Mountain Home, ID
Provider details
- NPI number
- 1073843868
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- John Stupak, President(267) 419-8913
Specialties & taxonomies
Residential Treatment Facilities
Practice location
2850 Industrial Way
Mountain Home, ID 83647-3960
Phone: (208) 587-2679
Fax: (208) 587-2875
Approximate (ZIP-level) locationGet directions
Mailing address
2850 Industrial Way
Mountain Home, ID 83647-3960
Other names (DBA / former)
- Doing business as
- Mountain Home Rtc
Registry dates
- Enumerated
- 2009-12-30
- Last updated
- 2009-12-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.