| Lz Behavioral Health, Llc | |
|
6142 W Corporal Ln Boise ID 83704-9316 | |
| (208) 614-0734 | |
| (208) 649-2805 |
| Full Name | Lz Behavioral Health, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6142 W Corporal Ln, Boise, Idaho |
| Authorized Official Name and Position | Tara Lzicar (OWNER) |
| Authorized Official Contact | 2086140734 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lz Behavioral Health, Llc Po Box 7251 Boise ID 83707-1251 Ph: (208) 614-0734 | Lz Behavioral Health, Llc 6142 W Corporal Ln Boise ID 83704-9316 Ph: (208) 614-0734 |
| NPI Number | 1235693284 |
|---|---|
| Provider Enumeration Date | 01/23/2019 |
| Last Update Date | 01/23/2019 |
| Medicare PECOS PAC ID | 1759822596 |
|---|---|
| Medicare Enrollment ID | O20240920001202 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235693284 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Julie Cathleen Hatfield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790237279 PECOS PAC ID: 3870856537 Enrollment ID: I20180410001923 |
| Provider Name | Tara Lzicar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740605112 PECOS PAC ID: 3577004316 Enrollment ID: I20240920001270 |
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