1871383158 NPI number — HARMONY MEDICAL AND PSYCHIATRIC SERVICES PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871383158 NPI number — HARMONY MEDICAL AND PSYCHIATRIC SERVICES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARMONY MEDICAL AND PSYCHIATRIC SERVICES PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871383158
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/09/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1846 1ST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IDAHO FALLS
Provider Business Mailing Address State Name:
ID
Provider Business Mailing Address Postal Code:
83401-4415
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
855-928-8778
Provider Business Mailing Address Fax Number:
857-270-7313

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6101 E HIGHWAY 54
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATHOL
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83801-6085
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
855-928-8778
Provider Business Practice Location Address Fax Number:
857-270-7313
Provider Enumeration Date:
05/09/2025

Additional Information

Authorized Official

Authorized Official Last Name:
HEPP
Authorized Official First Name:
LEILA
Authorized Official Middle Name:
R
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
857-928-8778

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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