IDAHO DEPT OF HEALTH & WELFARE AMH PSR BOISE (NPI# 1205966157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205966157 |
| Entity Type | Organization |
| Organization Name | IDAHO DEPT OF HEALTH & WELFARE AMH PSR BOISE |
| Practice Address |
1720 Westgate Dr Suite B-1 Boise ID 83704-7164 |
| Practice Telephone | 2083340894 |
| Practice Fax Number | 2083340804 |
| Mailing Telephone | 2083340894 |
| Mailing Fax Number | 2083340804 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | GINA WESTCOTT (PROGRAM MANAGER) |
| Authorized Official Telephone | 2083340969 |
| Authorized Official Credential | M.A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE SHIELD | 000010018973 | 01 | |
| BLUE CROSS OF IDAHO | HW280 | 01 | |
| ID | 0024207 | 05 |
| Street Address |
1720 WESTGATE DR SUITE B-1 |
| City | BOISE |
| State | ID |
| Zip Code | 83704-7164 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609811728 | Charles Terry Priscock | Social Worker | 1720 Westgate Dr, Boise, ID 83704-7164 | 2006-06-20 |
| 1891825824 | Idaho Dept of Health & Welfare Region 4 Cmh Psr Boise | Clinic/Center | 1720 Westgate Dr, Suite D, Boise, ID 83704-7164 | 2007-03-07 |
| 1205966249 | Idaho Dept of Health & Welfare Cmh Clinic Boise | Clinic/Center | 1720 Westgate Dr, Suite D, Boise, ID 83704-7164 | 2007-03-07 |
| 1487784435 | Idaho Dept of Health & Welfare Amh Clinic Boise | Clinic/Center | 1720 Westgate Dr, Suite B-1, Boise, ID 83704-7164 | 2007-03-07 |
| 1750423216 | Idaho Dept of Health & Welfare Esc Region 4 | Case Management | 1720 Westgate Dr, Suite B-2, Boise, ID 83704-7164 | 2007-02-13 |
| 1568502409 | Idaho Dept of Health & Welfare Itp Region 4 | Local Education Agency (LEA) | 1720 Westgate Dr, Suite B-2, Boise, ID 83704-7164 | 2007-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
| 1891304002 | Tree City Family Dental | Dentist | 7301 W. Emerald St Ste. 102, Boise, ID 83704 | 2020-07-24 |
| 1982230710 | Jessica Wynn Councell | Midwife | 1072 N Liberty St Ste 100, Boise, ID 83704 | 2020-03-12 |
| 1699307124 | Isabel Burns Bruce | Registered Nurse | 777 N Raymond Street, Boise, ID 83704 | 2020-02-12 |
| 1558903328 | Daring In Idaho, LLC | Social Worker | 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 | 2019-10-14 |
| 1053960286 | Kyle Hiromi Hatanaka | Acupuncturist | 9450 #120 Fairview Avenue, Boise, ID 83704 | 2019-09-10 |
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1588164727 | Cory Michael Sims | Counselor | 6550 W. Emerald St #112, Boise, ID 83704 | 2018-02-14 |
| 1477072270 | Matthew Lee Love | Non-emergency Medical Transport (VAN) | 6933 W. Stratton St, Boise, ID 83704 | 2017-09-12 |
| 1942735949 | Dalana Sue Thompson | Counselor | 9196 Emerald St Suite #130, Boise, ID 83704 | 2017-04-27 |
| Find all providers in zip 83704 | ||||
| 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 | ||||
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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.