IDAHO DEPT OF HEALTH & WELFARE REG 6 CMH BF C (NPI# 1710019476) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1710019476 |
Entity Type | Organization |
Organization Name | IDAHO DEPT OF HEALTH & WELFARE REG 6 CMH BF C |
Practice Address |
701 E Alice Blackfoot ID 83221-0129 |
Mailing Address |
Po Box 129 Blackfoot ID 83221-0129 |
Practice Telephone | 2087855826 |
Practice Fax Number | 2087851003 |
Mailing Telephone | 2087855826 |
Mailing Fax Number | 2087851003 |
Enumeration Date | 2007-03-09 |
Last Update Date | 2020-08-22 |
Authorized Official Name | ED AXFORD (PROGRAM MANAGER) |
Authorized Official Telephone | 2082347900 |
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 | 000010019402 | 01 |
ID | 8073650 | 05 | |
ID | BLUE CROSS | HW157 | 01 |
Street Address |
701 E ALICE |
City | BLACKFOOT |
State | ID |
Zip Code | 83221-0129 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932711165 | Samantha Paige Averett | Social Worker | 60 N Broadway, Blackfoot, ID 83221 | 2020-08-19 |
1730711656 | Sara Marie Letham | Family Medicine | 33 S Thompson Lane, Blackfoot, ID 83221 | 2020-02-08 |
1962994962 | Tyler Thomas Wood | Student in an Organized Health Care Education/Training Program | 98 Poplar Street, Blackfoot, Id 83221, Blackfoot, ID 83221 | 2018-06-05 |
1801336276 | Bmh, Inc. | Internal Medicine | 235 Poplar St, Blackfoot, ID 83221 | 2017-03-03 |
1497119804 | Susan Doran | Social Worker | 720 E. Alice, Blackfoot, ID 83221 | 2016-04-12 |
1427412121 | Josie Russell Adkins | Counselor | 720 East Alice, Blackfoot, ID 83221 | 2016-04-08 |
1740590314 | Ashley Nichole Thomas | Physician Assistant | 710 E. Alice Street, Blackfoot, ID 83221 | 2010-10-18 |
1528373313 | Stephanie Lynn Henderson | Dietitian, Registered | 1555 Vernon Ave, Blackfoot, ID 83221 | 2010-08-17 |
1184850141 | Joy H. Taylor | Nurse Practitioner | 1441 Parkway Drive, Blackfoot, ID 83221 | 2009-06-04 |
1427232925 | Nathan E. Sneddon | Anesthesiology | 98 Poplar St Fl 3, Blackfoot, ID 83221 | 2007-12-20 |
Find all providers in zip 83221 |
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 |
1639476294 | Idaho Dept of Health & Welfare Reg 2 Cmh | Clinic/Center | 1350 Troy Highway, Moscow, ID 83843-3995 | 2011-02-17 |
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 |
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.