Doctor Name: | DUSTIN SHARPE |
NPI Number: | 1780937532 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 32199 |
Business Practice Address: | 8050 W Northview St Boise, ID - 837047126 |
Business Phone Number: | 8053270504 |
Business Fax Number: | |
Mailing Address: | 9251 W Rifleman Ct, BOISE |
State: | ID |
Postal Code: | 837049737 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/17/2012 |
NPI Last Update Date: | 10/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 283Q00000X |
License Number: | 32199 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Hospitals |
Taxonomy Classification: | Psychiatric Hospital |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |