| Organization Name: | PSYCHIATRIC SERVICES BEHAVIORAL HEALTH CLINIC, INC. |
| NPI Number: | 1023435526 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CARMEN D BABB (OWNER) |
| Mailing Address: | 493 Eastland Drive Twin Falls |
| State: | ID US |
| Postal Code: | 83301 |
| Phone Number: | 2087320995 |
| Fax Number: | 2087320993 |
| NPI Enumeration Date: | 03/21/2014 |
| NPI Last Update Date: | 03/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |