EASTERSEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC. (NPI# 1770715062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770715062 |
| Entity Type | Organization |
| Organization Name | EASTERSEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC. |
| Practice Address |
1465 S Vinnell Way Boise ID 83709-1659 |
| Mailing Address |
425 1st Ave N Great Falls MT 59401-2507 |
| Practice Telephone | 2083393744 |
| Practice Fax Number | 2083393765 |
| Mailing Telephone | 4067613680 |
| Mailing Fax Number | 4067611390 |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2019-03-26 |
| Authorized Official Name | MARK SHERMAN (CFO) |
| Authorized Official Telephone | 4067713762 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558593830 | Easterseals-goodwill Northern Rocky Mountain, Inc. | Early Intervention Provider Agency | 5242 South 4820 West, Att Janet Wade, Kearns, UT 84118 | 2009-08-20 |
| 1730204116 | Easterseals-goodwill Northern Rocky Mountain, Inc. | Community/Behavioral Health | 1465 S Vinnell Way, Boise, ID 83709-1659 | 2007-03-21 |
| 1558486951 | Easterseals-goodwill Northern Rocky Mountain, Inc. | Community/Behavioral Health | 1607 N Parkcentre Pl, Nampa, ID 83651-1705 | 2007-03-21 |
| 1326137381 | Easterseals-goodwill Northern Rocky Mountain, Inc. | Day Training, Developmentally Disabled Services | 4400 Central Ave, Great Falls, MT 59405-1695 | 2006-10-11 |
| 1386144798 | Easterseals-goodwill Northern Rocky Mountain, Inc. | Hospice Care, Community Based | 425 1st Ave N, Great Falls, MT 59401-2507 | 2018-02-13 |
| 1386959575 | Easterseals-goodwill Northern Rocky Mountain, Inc. | Occupational Therapist | 350 S 400 E, Salt Lake City, UT 84111-2908 | 2010-08-11 |
| 1245418300 | Easterseals-goodwill Northern Rocky Mountain, Inc. | Community/Behavioral Health | 1607 N Parkcentre Pl, Nampa, ID 83651-1705 | 2008-01-31 |
| 1861601239 | Easterseals-goodwill Northern Rocky Mountain, Inc. | Community/Behavioral Health | 1607 N Parkcentre Pl, Nampa, ID 83651-1705 | 2007-05-22 |
| 1740305135 | Easterseals-goodwill Northern Rocky Mountain, Inc. | Community/Behavioral Health | 1408 W Hays St, Boise, ID 83702-5028 | 2007-03-21 |
| 1871624817 | Easterseals-goodwill Northern Rocky Mountain, Inc. | Nursing Care | 425 1st Ave N, Great Falls, MT 59401-2507 | 2007-03-09 |
| Street Address |
1465 S VINNELL WAY |
| City | BOISE |
| State | ID |
| Zip Code | 83709-1659 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730204116 | Easterseals-goodwill Northern Rocky Mountain, Inc. | Community/Behavioral Health | 1465 S Vinnell Way, Boise, ID 83709-1659 | 2007-03-21 |
| 1679699540 | Easter Seals-goodwill Northern Rocky Mountain, Inc. | Case Management | 1465 S Vinnell Way, Boise, ID 83709-1659 | 2007-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427655398 | Jayme Rossow | Occupational Therapist | 101 S. Allumbaugh Way, Boise, ID 83709 | 2020-10-05 |
| 1578195285 | Kara Taylor | Counselor | 9196 W Barnes St., Boise, ID 83709 | 2020-02-11 |
| 1164080164 | Elena Stamm | Audiologist | 10000 W Amity Rd, Boise, ID 83709 | 2019-06-04 |
| 1326550096 | Lawrence D Anderson Md Estate | Optometrist | 8955 W Hackamore Dr, Boise, ID 83709 | 2017-11-02 |
| 1457879975 | Mark Aaron Phelan | Registered Nurse | 779 S. Tennyson Way, Boise, ID 83709 | 2017-09-05 |
| 1235665290 | Sharon Nelson | Dietitian, Registered | 2790 S Goshen Way, Boise, ID 83709 | 2017-05-11 |
| 1982139622 | First Choice Healthcare, Inc. | Home Health | 12400 W. Overland Rd., Ste 100, Boise, ID 83709 | 2017-05-01 |
| 1801320254 | Deborah Carson | Social Worker | 8349 West Harmonica Way, Boise, ID 83709 | 2017-04-12 |
| 1114479862 | Allyson Anne Bates | Nurse Practitioner | 10583 W Lake Hazel Road, Samg Family Medicine, Boise, ID 83709 | 2016-10-28 |
| 1508221391 | Elisha L. Garrison | Counselor | 9196 W. Barnes Street, Boise, ID 83709 | 2015-12-21 |
| Find all providers in zip 83709 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477086114 | Teton Supported Living LLC | Day Training, Developmentally Disabled Services | 4101 N Creswell Way, Boise, ID 83713-2404 | 2017-04-10 |
| 1851734107 | Foundations for Independence LLC | Day Training, Developmentally Disabled Services | 2316 N Cole Rd Ste C, Boise, ID 83704-7365 | 2013-04-16 |
| 1700093796 | Progressive Behavior Services | Day Training, Developmentally Disabled Services | 9422 W Fairview Ave, Boise, ID 83704-8101 | 2007-05-17 |
| 1295948925 | Boise Services Group, Inc. | Day Training, Developmentally Disabled Services | 950 W State St, Boise, ID 83702-5440 | 2007-05-08 |
| 1871711598 | The Arc, Inc. | Day Training, Developmentally Disabled Services | 4402 Albion St, Boise, ID 83705-1324 | 2007-04-20 |
| 1922137355 | Progressive Behavior Services | Day Training, Developmentally Disabled Services | 9424 W Fairview Ave, Boise, ID 83704-8101 | 2007-03-02 |
| 1952437212 | Idaho Center for Autism, LLC | Day Training, Developmentally Disabled Services | 200 S Phillippi St, Boise, ID 83705-1152 | 2007-02-23 |
| 1841334885 | Employment Solutions, Inc. | Day Training, Developmentally Disabled Services | 260 S Cole Rd, Boise, ID 83709-0934 | 2007-02-15 |
| 1730396722 | Progressive Behavior Services | Day Training, Developmentally Disabled Services | 9424 W Fairview Ave, Boise, ID 83704-8101 | 2007-05-17 |
| 1649487638 | Progressive Behavior Services | Day Training, Developmentally Disabled Services | 9424 W Fairview Ave, Boise, ID 83704-8101 | 2007-05-17 |
| Find all providers in BOISE | ||||
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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.