IDAHODHWBH PAYETTAMHCLINIC (NPI# 1558498097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558498097 |
| Entity Type | Organization |
| Organization Name | IDAHODHWBH PAYETTAMHCLINIC |
| Practice Address |
515 16th Ave N Payette ID 83661-2047 |
| Practice Telephone | 2086426416 |
| Practice Fax Number | 2086422829 |
| Mailing Telephone | 2086426416 |
| Mailing Fax Number | 2086422829 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. TODD L HURT (FIELD OPERATIONS MANAGER) |
| Authorized Official Telephone | 2084557057 |
| Authorized Official Credential | M.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 8073592 | 05 | |
| ID | BLUESHIELD | 000010027633 | 01 |
| ID | BLUE CROSS OF IDAHO | HW298 | 01 |
| Street Address |
515 16TH AVE N |
| City | PAYETTE |
| State | ID |
| Zip Code | 83661-2047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689984254 | Idaho Dept of Health & Welfare | Clinic/Center | 515 16th Ave N, Payette, ID 83661-2047 | 2010-10-18 |
| 1154459444 | Idahodhwbh3 Payette Cmh Psr | Clinic/Center | 515 16th Ave N, Payette, ID 83661-2047 | 2007-03-01 |
| 1568590073 | Idahodhwbh3 Payette Amh Psr | Clinic/Center | 515 16th Ave N, Payette, ID 83661-2047 | 2007-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811279268 | Victoria L Wallace | Pharmacist | 405 S 8th Street, Payette, ID 83661 | 2011-09-12 |
| 1619056694 | James H Moore | Dentist | 925 2nd Ave No, Payette, ID 83661 | 2006-11-02 |
| 1831279538 | Justin Craig Smith | Dentist | 1105 3rd Ave North, Payette, ID 83661 | 2006-10-17 |
| 1710021506 | Dental Health Care With Heart | Dentist | 823 Center Ave, Payette, ID 83661 | 2007-02-16 |
| 1295781110 | Albertsons LLC | Durable Medical Equipment & Medical Supplies | 405 S Main St, Payette, ID 83661 | 2006-05-25 |
| 1225270523 | Norma Jean Hershey | Counselor | 695 2nd Ave S, North Entrance, Payette, ID 83661-0694 | 2009-04-01 |
| 1992773998 | Spooner Eye Care Sc | Optometrist | 1611 River St, Payette, ID 83661-2073 | 2006-03-08 |
| 1790949311 | Todd William Martinez | Massage Therapist | 815 River St, Payette, ID 83661-2179 | 2008-07-13 |
| 1750577219 | Daniel E Iwasa | Optometrist | 915 3rd Ave N, Payette, ID 83661-2403 | 2007-09-19 |
| 1730276080 | Janean Lewis | Dentist | 1105 3rd Ave N, Payette, ID 83661-2407 | 2006-10-06 |
| Find all providers in zip 83661 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972805224 | Emmett Counseling and Psychiatric Services, LLC | Clinic/Center | 501 N 16th St, 110, Payette, ID 83661-2781 | 2010-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942808019 | Helping Hearts Counseling Center, Pllc | Clinic/Center | 310 Cleveland Blvd, Caldwell, ID 83605-3624 | 2020-10-12 |
| 1811502438 | Dale Wilson Counseling and Evaluation | Clinic/Center | 6126 W State St Ste 101, Boise, ID 83703-2741 | 2020-09-10 |
| 1144843285 | Whole Health Counseling LLC | Clinic/Center | 2616 W Jefferson St, Boise, ID 83702-4713 | 2020-05-23 |
| 1033740865 | Jackie Nelson, Pllc | Clinic/Center | 202 N 9th St Ste 401c, Boise, ID 83702-5770 | 2020-01-30 |
| 1437621646 | Joanne Burgio Phd LLC | Clinic/Center | 3061 S Meridian Rd Ste 150, Meridian, ID 83642-7962 | 2018-12-28 |
| 1700394822 | Lookout Behavioral Health LLC | Clinic/Center | 7905 N Meadowlark Way Ste A, Coeur D Alene, ID 83815-5041 | 2018-01-11 |
| 1346759495 | Pacific Mind Institute | Clinic/Center | 2596 N Stokesberry Pl Ste 165, Meridian, ID 83646-6281 | 2017-09-20 |
| 1336599976 | Easy Go Express | Clinic/Center | 3551 W Antelope Rd, Moore, ID 83255-8754 | 2016-06-14 |
| 1669808614 | Integrated Interventions LLC | Clinic/Center | 2482 E. Glacier Rd., Hayden Lake, ID 83835 | 2013-09-23 |
| 1447695630 | Susan M. Beglinger, Ltd | Clinic/Center | 206 E Indiana Ave, Suite 112, Coeur D Alene, ID 83814-2969 | 2013-05-01 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on IDAHODHWBH PAYETTAMHCLINIC.
| 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.