| Organization Name: | TREASURE VALLEY BEHAVIORAL HEALTH, LLC |
| NPI Number: | 1093018939 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRADI C FRITTS (OWNER) |
| Mailing Address: | 131 N Whitley Dr Fruitland |
| State: | ID US |
| Postal Code: | 836192430 |
| Phone Number: | 2084527705 |
| Fax Number: | 2084527750 |
| NPI Enumeration Date: | 12/15/2010 |
| NPI Last Update Date: | 07/02/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |