MY BROTHER'S KEEPER MBK (NPI# 1952674988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952674988 |
| Entity Type | Organization |
| Organization Name | MY BROTHER'S KEEPER MBK |
| Practice Address |
704 S Cole Rd Boise ID 83709-1861 |
| Practice Telephone | 2083394356 |
| Mailing Telephone | 2083394356 |
| Enumeration Date | 2012-02-22 |
| Last Update Date | 2013-03-14 |
| Authorized Official Name | MS. PATTI JOLEEN SUMMERS (OWNER) |
| Authorized Official Telephone | 2083394356 |
| Authorized Official Credential | CPRP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
ID | Ambulatory Health Care Facilities | |
| N | 251S00000X | Community/Behavioral Health | ID | Agencies | |
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 251B00000X | Case Management | Agencies | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
704 S COLE RD |
| City | BOISE |
| State | ID |
| Zip Code | 83709-1861 |
| 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 | 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 |
|---|---|---|---|---|
| 1871126797 | Avanzar Wellness LLC | Clinic/Center | 11513 W Fairview Ave Ste 105, Boise, ID 83713-7887 | 2020-02-19 |
| 1689236648 | Rahmana Elizabeth Sayre | Clinic/Center | 750 E Warm Springs Ave Ste D1, Boise, ID 83712-6457 | 2019-06-30 |
| 1235693284 | Lz Behavioral Health, LLC | Clinic/Center | 6142 W Corporal Ln, Boise, ID 83704-9316 | 2019-01-23 |
| 1750882635 | Melissa Ruth Lcpc LLC | Clinic/Center | 1015 W Hays St Ste 207, Boise, ID 83702-5424 | 2018-02-26 |
| 1598276438 | Booth Psychological Solutions, Pllc | Clinic/Center | 13945 W Wainwright Dr Ste 106, Boise, ID 83713-1925 | 2017-10-18 |
| 1215469440 | Mental Health Solutions LLC | Clinic/Center | 3152 S Bown Way Ste 102, Boise, ID 83706-5456 | 2017-03-28 |
| 1790171213 | Cloud Clinic Mental Health | Clinic/Center | 2577 S Five Mile Rd, Boise, ID 83709-2325 | 2015-04-10 |
| 1487922902 | Healthy Place Counseling Boise LLC | Clinic/Center | 2589 S Five Mile Rd, Boise, ID 83709-2325 | 2011-12-12 |
| 1114058062 | Leyline Advocates, LLC | Clinic/Center | 2210 Broadway Ave Ste 202, Boise, ID 83706-4666 | 2007-03-09 |
| 1083246904 | The Counseling Center At Tree City Church | Clinic/Center | 3852 N Eagle Rd, Boise, ID 83713-0750 | 2020-02-08 |
| Find all providers in BOISE | ||||
Please comment or provide details below to improve the information on MY BROTHER'S KEEPER MBK.
| 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.