| Behavioral Enhancement Services & Treatment Llc | |
|
1001 N 7th Ave Ste 115 Pocatello ID 83201-5786 | |
| (208) 909-5177 | |
| Not Available |
| Full Name | Behavioral Enhancement Services & Treatment Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1001 N 7th Ave Ste 115, Pocatello, Idaho |
| Authorized Official Name and Position | Demi Echi-aboli (BILLING DEPARTMENT DIRECTOR) |
| Authorized Official Contact | 2083601038 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Enhancement Services & Treatment Llc Po Box 2811 Idaho Falls ID 83403-2811 Ph: () - | Behavioral Enhancement Services & Treatment Llc 1001 N 7th Ave Ste 115 Pocatello ID 83201-5786 Ph: (208) 909-5177 |
| NPI Number | 1457949539 |
|---|---|
| Provider Enumeration Date | 01/05/2021 |
| Last Update Date | 11/13/2024 |
| Certification Date | 11/13/2024 |
| Medicare PECOS PAC ID | 2567997349 |
|---|---|
| Medicare Enrollment ID | O20241203002728 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457949539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Tamara Melville |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760538805 PECOS PAC ID: 0143488668 Enrollment ID: I20231130003911 |
| Provider Name | Madison N Paulsen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679315386 PECOS PAC ID: 3870028707 Enrollment ID: I20241202000323 |
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