Organization · Type 2 NPI

Legacy Healthcare Group

Psychiatric/Mental Health Nurse Practitioner · Pocatello, ID

NPI number 1841108347 Active

Practice location

5230 W Moonlight Mine Rd
Pocatello, ID 83201-9013

Call (954) 548-7312 Map

Fax (954) 548-7312

Mailing address

66 W Flagler St Ste 900
Miami, FL 33130-1807

Specialties and licenses

Taxonomy	Code	License
Psychiatric/Mental Health Nurse Practitioner Primary	363LP0808X	None listed

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

3 other providers at this address

Moonlight Mountain Recovery, IncSubstance Abuse Rehabilitation Facility Pocatello, ID NPI 1861983413
Emily K. Flint, LCPCMental Health Counselor Pocatello, ID NPI 1831873975
Zachary Kinney, RECOVERY COACHPeer Specialist Pocatello, ID NPI 1619694312

Other psychiatric/mental health nurse practitioner providers in Pocatello

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About NPI 1841108347

Legacy Healthcare Group's National Provider Identifier is 1841108347, issued on Aug 28, 2026. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Pocatello, ID. The record was last updated on Aug 28, 2026.