| Perma Mental Health Pllc | |
|
950 W Bannock St Ste. 1100 Boise ID 83702-5999 | |
| (208) 319-3513 | |
| (208) 350-6674 |
| Full Name | Perma Mental Health Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 950 W Bannock St, Boise, Idaho |
| Authorized Official Name and Position | Alexander Wills (OWNER/PSYCHIATRIST) |
| Authorized Official Contact | 2083193513 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Perma Mental Health Pllc 950 W Bannock St Ste. 1100 Boise ID 83702-5999 Ph: (208) 996-1700 | Perma Mental Health Pllc 950 W Bannock St Ste. 1100 Boise ID 83702-5999 Ph: (208) 319-3513 |
| NPI Number | 1104214618 |
|---|---|
| Provider Enumeration Date | 01/06/2015 |
| Last Update Date | 02/03/2023 |
| Certification Date | 02/03/2023 |
| Medicare PECOS PAC ID | 3577887041 |
|---|---|
| Medicare Enrollment ID | O20150112001155 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104214618 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD 12500 (Idaho) | Primary |
| Provider Name | Julie Akins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285811505 PECOS PAC ID: 5395823538 Enrollment ID: I20080429000104 |
| Provider Name | Alex B Wills |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649597055 PECOS PAC ID: 1456579564 Enrollment ID: I20140903001666 |
| Provider Name | Tyson J Flower |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184258311 PECOS PAC ID: 3173940319 Enrollment ID: I20200826002658 |
| Provider Name | Craig C Hope |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881212942 PECOS PAC ID: 2062824394 Enrollment ID: I20201210001613 |
| Provider Name | Tauna Marie Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588277529 PECOS PAC ID: 1557754041 Enrollment ID: I20220204001090 |
| Provider Name | Jon Patxi Criswell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881301075 PECOS PAC ID: 3173995677 Enrollment ID: I20230209002041 |
| Provider Name | Cheryl Kathryn Burris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225669534 PECOS PAC ID: 5597120824 Enrollment ID: I20230420001496 |
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