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Sequel Tsi of Idaho, LLC — NPI 1740532118, Mountain Home, ID | NPI Central

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NPI 1740532118

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Sequel Tsi of Idaho, LLC

NPI 1740532118 · Adult Mental Health Clinic/Center · Mountain Home, ID

Provider details

NPI number: 1740532118
Entity type: Organization
Primary specialty: Adult Mental Health Clinic/CenterAmbulatory Health Care Facilities
Parent organization: Sequel Tsi Holdings
Organization subpart: Yes
Authorized official: Chris Banken, Sr. Vice President of Operations(602) 335-2095

Specialties & taxonomies

Adult Mental Health Clinic/CenterPrimary261QM0850X
Ambulatory Health Care Facilities

Practice location

2850 Industrial Way

Mountain Home, ID 83647-3960

Phone: (208) 587-2679

Approximate (ZIP-level) locationGet directions

More ID providers

Mailing address

2850 Industrial Way

Mountain Home, ID 83647-3960

Other names (DBA / former)

Doing business as: Mountain Home

Registry dates

Enumerated: 2012-10-10
Last updated: 2012-10-10

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.