IDAHO DEPT OF HEALTH & WELFARE REG 2 CMH (NPI# 1639476294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639476294 |
| Entity Type | Organization |
| Organization Name | IDAHO DEPT OF HEALTH & WELFARE REG 2 CMH |
| Practice Address |
1350 Troy Highway Moscow ID 83843-3995 |
| Practice Telephone | 2088820562 |
| Mailing Telephone | 2088820562 |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2011-02-17 |
| Authorized Official Name | VICKI MALONE (PROGRAM MANAGER) |
| Authorized Official Telephone | 2087994440 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE SHIELD | 000010018450 | 01 |
| ID | BLUE CROSS | HW140 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518264845 | Idaho Dept of Health & Welfare Reg 2 Cmh | Clinic/Center | 1118 F St, Po Drawer B, Lewiston, ID 83501-1930 | 2011-02-23 |
| 1407153737 | Idaho Dept of Health & Welfare Reg 2 Cmh | Clinic/Center | 216 S C St, Grangeville, ID 83530-1342 | 2011-02-23 |
| Street Address |
1350 TROY HIGHWAY |
| City | MOSCOW |
| State | ID |
| Zip Code | 83843-3995 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558668111 | Idaho Dept of Health & Welfare Reg 2 Amh | Clinic/Center | 1350 Troy Highway, Moscow, ID 83843-3995 | 2011-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033726880 | Moscow Physical Therapy, LLC | Clinic/Center | 1174 Alturas Drive, Suite 2, Moscow, ID 83843 | 2020-09-25 |
| 1831703057 | Hydee Flishaw Tubbs Becker | Dietitian, Registered | 614 North Hayes Street, Moscow, ID 83843 | 2020-09-04 |
| 1528626959 | Ryan Steven Clark | Student in an Organized Health Care Education/Training Program | 212 Farm Road, #201, Moscow, ID 83843 | 2019-05-31 |
| 1770141384 | Lingwen Zhang | Specialist/Technologist | 901 Paradise Creek Rd, Moscow, ID 83843 | 2019-05-30 |
| 1306363478 | Elizabeth Campbell | Dietitian, Registered | 611 S. Main, Moscow, ID 83843 | 2017-08-29 |
| 1598285496 | Gina Cretser | Counselor | 212 Rodeo Dr. #410, Moscow, ID 83843 | 2017-06-21 |
| 1124558721 | Morgan Leigh Derloshon | Specialist/Technologist | 275 Southview Ave, Apt 206, Moscow, ID 83843 | 2017-06-15 |
| 1619411790 | Kaylene Howard | Massage Therapist | 127 South Washington, Suite 6, Moscow, ID 83843 | 2016-12-08 |
| 1407237043 | Jacob Kent Christensen | Family Medicine | 831 S Ash St, Moscow, ID 83843 | 2015-06-09 |
| 1366851388 | Elisabeth Henry | Pharmacist | 2740 West Pullman Rd, Moscow, ID 83843 | 2014-08-04 |
| Find all providers in zip 83843 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508405945 | Nate Bonovitz Counseling, LLC | Clinic/Center | 1151 E Iron Eagle Dr, Eagle, ID 83616-6854 | 2020-01-02 |
| 1720620750 | Jim Smidt | Clinic/Center | 820 N William St, Post Falls, ID 83854-5123 | 2019-10-10 |
| 1225507668 | Summus Counseling, LLC | Clinic/Center | 211 S Woodruff Ave Ste 13, Idaho Falls, ID 83401-4324 | 2018-11-14 |
| 1750705687 | Answers, LLC | Clinic/Center | 527 W 20th St, Idaho Falls, ID 83402-4421 | 2014-02-12 |
| 1124372370 | A Plus Solutions Center | Clinic/Center | 2311 Parke Ave. Unit 3, Suite 12, Burley, ID 83318 | 2012-11-08 |
| 1598012700 | Tueller Counseling Services | Clinic/Center | 2275 West Broadway Suite G, Idaho Falls, ID 83402 | 2012-08-07 |
| 1952674988 | My Brother's Keeper Mbk | Clinic/Center | 704 S Cole Rd, Boise, ID 83709-1861 | 2012-02-22 |
| 1154639714 | Eartherapy | Clinic/Center | 354 W Sunnyside Rd, Suite D, Idaho Falls, ID 83402-4644 | 2010-09-16 |
| 1104048503 | Community Partnerships of Idaho, Inc. | Clinic/Center | 3214 N Acre Ln, Boise, ID 83704-4501 | 2007-05-03 |
| 1265654461 | About Balance Mental Health LLC | Clinic/Center | 6550 Emerald St, Suite 112, Boise, ID 83704 | 2007-05-03 |
| 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.