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BREVITY TREATMENT SERVICES

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Company Details

Name: BREVITY TREATMENT SERVICES
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Active-Current
Date of registration: 09 Oct 2007 (18 years ago)
Entity Number: 355837
Place of Formation: IDAHO
File Number: 0000355837
ZIP code: 83814
County: Kootenai County
Mailing Address: 950 W IRONWOOD DR STE 2 COEUR D'ALENE, ID 83814

National Provider Identifier

NPI Number:
1881113413
Certification Date:
2024-04-19

Authorized Person:

Name:
REBECCA BOSCH
Role:
OWNER/CLINICIAN
Phone:

Taxonomy:

Selected Taxonomy:
101YA0400X - Addiction (Substance Use Disorder) Counselor
Is Primary:
No
Selected Taxonomy:
101YM0800X - Mental Health Counselor
Is Primary:
No
Selected Taxonomy:
101YP2500X - Professional Counselor
Is Primary:
Yes

Contacts:

Fax:
8774712556

Filing

Filing Name Filing Number Filing date
Legacy Amendment 0000868962 2016-04-07
Legacy Amendment 0000868963 2010-05-05
Initial Filing 0000355837 2007-10-09

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Date of last update: 25 Sep 2024

Sources: Idaho Secretary of State