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Bannock Youth Foundation
Substance Abuse Rehabilitation Facility in Pocatello, Idaho
NPI 1245665470

Bannock Youth Foundation is a Substance Abuse Rehabilitation Facility based in Pocatello, ID. Bannock Youth Foundation practices in Pocatello, ID. The NPI Number for Bannock Youth Foundation is 1245665470 and holds a License No. (Idaho).

The current practice location address for Bannock Youth Foundation is 110 South 19Th, Pocatello, ID and can be reached out via phone at 208-234-4722 and via fax at 208-234-2135.

Location: 110 South 19Th, Pocatello, ID, 83204
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1245665470
Provider Name
Bannock Youth Foundation
Credential
Provider Entity Type
Organization
Address
110 South 19Th, Pocatello, ID, 83204
Phone Number
208-234-4722
Fax Number
208-234-2135
Provider Enumeration Date
09/06/2013
Last Update Date
03/12/2024
institution
Provider Business Practice Location Address Details
Address
110 South 19Th
City
Pocatello
State
Idaho
Zip
83201
Phone Number
208-234-4722
Fax Number
208-234-2135
person
Provider Business Mailing Address Details
Address
110 South 19Th
City
Pocatello
State
Idaho
Zip
83201
Phone Number
208-234-4722
Fax Number
208-234-2135
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
-
Taxonomy
324500000X
License No.
()
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
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