AMY HERZOG


Address: 175 Brome Dr., #7, Victor, ID 83455
Phone: 4063601631

AMY HERZOG (NPI# 1861534133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1861534133
Entity Type Individual
Full Name AMY HERZOG
Credential LCSW
Practice Address 175 Brome Dr.
#7
Victor
ID 83455
Mailing Address 175 Brome Dr.
7
Victor
ID 83455
Practice Telephone 4063601631
Mailing Telephone 4063601631
Enumeration Date 2007-02-13
Last Update Date 2009-10-14
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 101Y00000X Counselor WY Behavioral Health & Social Service Providers
Y 251C00000X Day Training, Developmentally Disabled Services Agencies

Other Providers AMY HERZOG

NPI Name Taxonomy Address Enumeration
1467856013 Amy Herzog Dental Assistant 12711 Se Mill Plain Blvd, Vancouver, WA 98684-6053 2014-10-10

Office Location

Street Address 175 BROME DR.
#7
City VICTOR
State ID
Zip Code 83455

Providers in the same zip code

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1376050385 Hunters Inc Pharmacy 81 N. Main St., Victor, ID 83455 2017-12-29
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1073918173 Teton Valley Vision PC Optometrist 7389 S Hwy 33, Ste B, Victor, ID 83455 2014-10-31
1437440591 Nathan Richard George Dentist 7726 Lupine Lane, Victor, ID 83455 2011-04-25
1245537695 Erin N Borbet Acupuncturist 108 W Center St Unit 3, Victor, ID 83455 2011-02-22
1336457837 Grand Teton Dental Care Clinic/Center 741 South 50 West, Suite A, Victor, ID 83455 2010-09-17
1598086126 Childs Play, LLC Speech-Language Pathologist 73 North Main, Victor, ID 83455 2010-06-17
1891025656 Phillips Therapy Incorporated Occupational Therapist 73 North Main St., Suite 3, Victor, ID 83455 2009-12-30
1861621278 Elmer Raymond Cherry Iv Dentist 7389 S. Hwy. 33 Suite A, Victor, ID 83455 2009-07-07
1902978323 James K Davis Chiropractor 164 North Main Street, Victor, ID 83455 2006-11-14
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Taxonomy Information

Taxonomy Code 251C00000X
Grouping Agencies
Classification Day Training, Developmentally Disabled Services

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1902205230 Andrea Loban Day Training, Developmentally Disabled Services 5049 Fox Creek Hollow, Victor, ID 83455-0000 2014-08-22

Providers in the same taxonomy and state

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
1962889055 Community Connections South Central Day Training, Developmentally Disabled Services 212 2nd Ave W, #102 & 104, Twin Falls, ID 83301-6016 2015-04-28
1154714897 Phoenix Management LLC Day Training, Developmentally Disabled Services 10991 Deerridge Dr., Chubbuck, ID 83202 2015-03-05
1336570118 Independent Living Specialists, LLC Day Training, Developmentally Disabled Services 379 Yellowstone Ave, Pocatello, ID 83201-4529 2013-12-04
1871935064 Community Connections North, Inc. Day Training, Developmentally Disabled Services 1230 N Northwood Center Ct, Suite A, Coeur D Alene, ID 83814-4941 2013-07-29
1851734107 Foundations for Independence LLC Day Training, Developmentally Disabled Services 2316 N Cole Rd Ste C, Boise, ID 83704-7365 2013-04-16
1679816912 A New Hope, LLC Day Training, Developmentally Disabled Services 19b Mountain Dr, Pocatello, ID 83204 2013-04-05
1457694176 A Plus Solutions Center Day Training, Developmentally Disabled Services 2311 Park Ave, Unit 3, Suite 12, Burley, ID 83318-2104 2013-04-01
1518208966 Learning Garden Developmental Preschool Day Training, Developmentally Disabled Services 412 E Mullan Ave, Post Falls, ID 83854-7641 2013-03-11
1831442805 A Plus Solutions Developmental Center LLC Day Training, Developmentally Disabled Services 2251 Overland Avenue, Suite Number 5, Burley, ID 83318 2012-10-16
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Competitor

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City VICTOR
Zip Code 83455

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Dataset Information

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.

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