| Reenvision Behavioral Health Pllc | |
|
1219 E Highway 81 Byp Declo ID 83323 | |
| (208) 219-5059 | |
| Not Available |
| Full Name | Reenvision Behavioral Health Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1219 E Highway 81 Byp, Declo, Idaho |
| Authorized Official Name and Position | Olga Esquivel Lira (OWNER/ THERAPIST) |
| Authorized Official Contact | 2082195059 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Reenvision Behavioral Health Pllc Po Box 242 Declo ID 83323-0242 Ph: (208) 219-5059 | Reenvision Behavioral Health Pllc 1219 E Highway 81 Byp Declo ID 83323 Ph: (208) 219-5059 |
| NPI Number | 1235003088 |
|---|---|
| Provider Enumeration Date | 10/03/2025 |
| Last Update Date | 10/03/2025 |
| Certification Date | 09/18/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235003088 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Family Health Services Corporation Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 205 E Main St, Declo, ID 83323 Phone: 208-678-0101 Fax: 208-678-0303 |