| Valiant Mental Health Pllc | |
|
6248 W Airhorn Ave Rathdrum ID 83858-8014 | |
| (208) 444-9820 | |
| Not Available |
| Full Name | Valiant Mental Health Pllc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 6248 W Airhorn Ave, Rathdrum, Idaho |
| Authorized Official Name and Position | Randy P Goleman (PMHNP-BC) |
| Authorized Official Contact | 2084449820 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valiant Mental Health Pllc 6248 W Airhorn Ave Rathdrum ID 83858-8014 Ph: () - | Valiant Mental Health Pllc 6248 W Airhorn Ave Rathdrum ID 83858-8014 Ph: (208) 444-9820 |
| NPI Number | 1316758246 |
|---|---|
| Provider Enumeration Date | 01/20/2025 |
| Last Update Date | 03/11/2025 |
| Certification Date | 03/11/2025 |
| Medicare PECOS PAC ID | 7012437775 |
|---|---|
| Medicare Enrollment ID | O20250225001388 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316758246 | NPI | - | NPPES |
| Provider Name | Randy Paul Goleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104542109 PECOS PAC ID: 8921528688 Enrollment ID: I20250225001487 |
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