GARNET STATE ENTERPRISES LLC
NPI 1184433005
Nurse Practitioner - Psychiatric/Mental Health in Hayden, ID

Q: What is Garnet State Enterprises LLC's NPI number?

The NPI number for Garnet State Enterprises LLC is 1184433005. It was assigned to this organization in the NPPES registry on January 6, 2025.

Q: What is Garnet State Enterprises LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since January 06, 2025

2481 HALLEBERRY, HAYDEN, ID 83835(208) 518-9927 Get Directions Write a Review

NPPES record last updated: January 6, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Garnet State Enterprises Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GARNET STATE ENTERPRISES LLC (NPI 1184433005) is a healthcare organization registered as a psychiatric/mental health in Hayden, Idaho and active in the NPI registry since January 2025. The organization lists Peter Gordon Gourley, Psychiatric Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1184433005

Entity TypeOrganization

Primary Taxonomy363LP0808X

Legal Business NameGARNET STATE ENTERPRISES LLC

Location Address2481 HALLEBERRYHayden, ID 83835-8339

Mailing Address2481 HalleberryHayden, ID 83835-8339 · (208) 518-9927

Phone(208) 518-9927

Organization SubpartNo

Authorized OfficialPeter Gordon GourleyPsychiatric Nurse Practitioner · (208) 518-9927

Enumeration DateJanuary 6, 2025

NPPES CertifiedJanuary 6, 2025

✔ NPI 1184433005 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

2481 HALLEBERRY, Hayden, ID 83835

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Garnet State Enterprises LLC's NPI number?

The NPI number for Garnet State Enterprises LLC is 1184433005. It was assigned to this organization in the NPPES registry on January 6, 2025.

Where is Garnet State Enterprises LLC located?

Garnet State Enterprises LLC is located at 2481 Halleberry, Hayden, ID 83835. The listed phone number is (208) 518-9927.

What is Garnet State Enterprises LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Garnet State Enterprises LLC was last updated on January 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.