IDAHODHWBH3 PAYETTE AMH PSR (NPI# 1568590073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568590073 |
| Entity Type | Organization |
| Organization Name | IDAHODHWBH3 PAYETTE AMH PSR |
| 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 | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 8073591 | 05 | |
| ID | BLUE CROSS OF IDAHO | HW298 | 01 |
| ID | BLUESHIELD | 000010027633 | 01 |
| Street Address |
515 16TH AVE N |
| City | PAYETTE |
| State | ID |
| Zip Code | 83661-2047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558498097 | Idahodhwbh Payettamhclinic | Clinic/Center | 515 16th Ave N, Payette, ID 83661-2047 | 2007-02-28 |
| 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 |
| 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 | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598364978 | Brave Ahead Counseling | Clinic/Center | 991 Sunset Rd, Athol, ID 83801-9287 | 2020-10-18 |
| 1356959191 | Healing Minds LLC | Clinic/Center | 6586 W Flagstaff St, Rathdrum, ID 83858-8203 | 2020-07-17 |
| 1487273637 | Answers, LLC - Cbrs | Clinic/Center | 855 N Capital Ave Ste 1, Idaho Falls, ID 83402-3405 | 2020-04-08 |
| 1649808767 | Psychological Preventative Health Pllc | Clinic/Center | 4831 Greystone Ln, Idaho Falls, ID 83404-8338 | 2020-04-01 |
| 1073148623 | Begin Within Counseling, LLC | Clinic/Center | 943 W Overland Rd Ste 111, Meridian, ID 83642-6541 | 2020-03-04 |
| 1871126797 | Avanzar Wellness LLC | Clinic/Center | 11513 W Fairview Ave Ste 105, Boise, ID 83713-7887 | 2020-02-19 |
| 1174155741 | Noble Intent | Clinic/Center | 1406 N Main St Ste 204, Meridian, ID 83642-1746 | 2020-02-11 |
| 1194362517 | Advanced Counseling LLC | Clinic/Center | 39 W Pine Ave, Meridian, ID 83642-2281 | 2019-12-04 |
| 1629615406 | Building A Life Worth Living, LLC | Clinic/Center | 771 S Woodruff Ave, Idaho Falls, ID 83401-5286 | 2019-11-29 |
| 1750927281 | Weme Counseling and Clinical Consultation | Clinic/Center | 231 N Third Ave Ste 207, Sandpoint, ID 83864-1418 | 2019-11-19 |
| Find all providers with the same taxonomy | ||||
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| 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.