PATHWAYS OF IDAHO, LLC (NPI# 1326466988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326466988 |
| Entity Type | Organization |
| Organization Name | PATHWAYS OF IDAHO, LLC |
| Other Organization Name | ACES COMMUNITY SERVICES |
| Practice Address |
5583 N Glenwood St Boise ID 83714-1336 |
| Practice Telephone | 2082872564 |
| Practice Fax Number | 2082872570 |
| Mailing Telephone | 2082872564 |
| Mailing Fax Number | 2082872570 |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2016-12-06 |
| Authorized Official Name | MS. KRISTI OLSON (IDAHO STATE DIRECTOR) |
| Authorized Official Telephone | 2082872564 |
| Is Organization Subpart | Y |
| Parent Organization Name | PATHWAYS HEALTH AND COMMUNITY SUPPORT, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | MEDICARE PTAN | 20004720 | 01 |
| Other Name | Type Code |
|---|---|
| ACES Community Services | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PATHWAYS OF IDAHO, LLC | 545 N. Benjamin Ste 185, Boise, ID 83704-9625 |
| Street Address |
5583 N GLENWOOD ST |
| City | BOISE |
| State | ID |
| Zip Code | 83714-1336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720429640 | Lianna Erickson-trembath | Counselor | 5583 N Glenwood St, Boise, ID 83714-1336 | 2013-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932683752 | Ikdo State Street LLC | Dentist | 9209 W State St, Garden City, ID 83714 | 2018-09-18 |
| 1437608007 | Carrie Boroughs Breaux | Ophthalmology | 5019 N Sawyer Ave, Garden City, ID 83714 | 2016-09-23 |
| 1841646007 | Alliance Medical Group, LLC | Family Medicine | 5601 W. Chinden Blvd., Garden City, ID 83714 | 2016-05-06 |
| 1134580467 | Rebecca Gillet | Physical Therapist | 6576 W Dufferin Ct, Boise, ID 83714 | 2016-03-15 |
| 1063816007 | Ingri Suzanne Koloski | Counselor | 8969 West Hepburn Lane, Garden City, ID 83714 | 2014-10-20 |
| 1679909329 | Anile Nina | Counselor | 5484 N Gary Lane, Boise, ID 83714 | 2013-09-25 |
| 1215360292 | William Blake Bybee | Dentist | 5833 W. Hidden Springs Dr., Boise, ID 83714 | 2013-08-14 |
| 1871833327 | Charmaine Read | Social Worker | 123 E. 44th St, Ste. A, Garden City, ID 83714 | 2013-02-20 |
| 1811206576 | Bennett Medical Services | Durable Medical Equipment & Medical Supplies | 5220 Sawyer Court, Suite D, Garden City, ID 83714 | 2010-09-29 |
| 1073780680 | Barry Lynn Williams | Pharmacist | 7020 W State Street, Boise, ID 83714 | 2008-05-13 |
| Find all providers in zip 83714 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053938779 | Halo Health Services LLC | Community/Behavioral Health | 1111 S Orchard St, Boise, Id 83705, Boise, ID 83705 | 2020-06-29 |
| 1245854454 | Ken Wells Counseling | Community/Behavioral Health | 6654 E Bend Ridge St, Boise, ID 83716-5623 | 2020-06-03 |
| 1083236079 | Nakale Ball | Community/Behavioral Health | 3861 N Maple Grove Rd, Boise, ID 83704-4227 | 2020-05-12 |
| 1043859002 | Kacey E Mueller | Community/Behavioral Health | 688 N Avenue H Apt 304, Boise, ID 83712-6471 | 2019-12-22 |
| 1407499270 | Acceptance Counseling Services | Community/Behavioral Health | 5440 W Franklin Rd Ste 200, Boise, ID 83705-6434 | 2019-10-23 |
| 1154817021 | Hand In Hand | Community/Behavioral Health | 1830 W Airport Way, Boise, ID 83705-5101 | 2018-07-03 |
| 1982126264 | Brc Mental Health Services | Community/Behavioral Health | 963 S Orchard St Ste 103, Boise, ID 83705-1917 | 2017-07-08 |
| 1689109613 | Mrl Counseling LLC | Community/Behavioral Health | 9442 W Fairview Ave, Boise, ID 83704-8101 | 2017-04-27 |
| 1639601636 | Family Connection, Inc. | Community/Behavioral Health | 7154 W State St # 278, Boise, ID 83714-7421 | 2017-03-29 |
| 1164964045 | Jaimie Cain LLC | Community/Behavioral Health | 2210 N 31st St, Boise, ID 83703-5626 | 2016-11-09 |
| Find all providers in BOISE | ||||
Please comment or provide details below to improve the information on PATHWAYS OF IDAHO, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.