IDAHO DEPT OF HEALTH & WELFARE R5 AMH CL RUP


Address: 209 S 2nd St, Rupert, ID 83350-2104
Phone: 2084369494

IDAHO DEPT OF HEALTH & WELFARE R5 AMH CL RUP (NPI# 1225169915) 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) 1225169915
Entity Type Organization
Organization Name IDAHO DEPT OF HEALTH & WELFARE R5 AMH CL RUP
Practice Address 209 S 2nd St
Rupert
ID 83350-2104
Practice Telephone 2084369494
Mailing Telephone 2084369494
Enumeration Date 2007-03-07
Last Update Date 2007-07-09
Authorized Official Name DUKE MORTON (FIELD SERVICES PROGRAM MANAGER)
Authorized Official Telephone 2087362177

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM0850X Clinic/Center
Specialization: Adult Mental Health
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
ID BLUESHIELD 000010025421 01
ID 8073772 05
ID BLUE CROSS HW173 01

Office Location

Street Address 209 S 2ND ST
City RUPERT
State ID
Zip Code 83350-2104

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1417349515 Robbie Joe Carroll Registered Nurse 1024 8th Street, Family Health Services, Rupert, ID 83350 2015-02-26
1285921643 Duane Broderick Counselor 2311 Parke Ave., Ste. 8, Burley, ID 83350 2011-07-06
1598798282 Kerry W Saurey Family Medicine 1218 9th St, Ste 7, Rupert, ID 83350 2006-07-08
1093761694 Family Health Services Corporation Dental Hygienist 402 6th St, Rupert, ID 83350 2006-05-25
1376531004 Jeffrey Scott Swenson Family Medicine 1308 8th St Ste 1, Rupert, ID 83350 2005-10-06
1205312774 Shawna M Mccaffrey Nurse Practitioner 1308 8th St, Rupert, ID 83350 2018-07-17
1386872810 Brian R Muir Family Medicine 1308 8th St Ste 1, Rupert, ID 83350 2009-06-23
1083816334 Cameron Mchan Nurse Practitioner 1308 8th St Ste 1, Rupert, ID 83350 2007-05-31
1134225956 Margo Saunders Specialist 1308 8th St Ste 1, Rupert, ID 83350 2006-09-16
1619900305 Don C Pates Family Medicine 1218 9th St, Ste 7, Rupert, ID 83350 2006-07-08
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Taxonomy Information

Taxonomy Code 261QM0850X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Adult Mental Health

Taxonomy Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
Notes: [7/1/2003: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1942808019 Helping Hearts Counseling Center, Pllc Clinic/Center 310 Cleveland Blvd, Caldwell, ID 83605-3624 2020-10-12
1811502438 Dale Wilson Counseling and Evaluation Clinic/Center 6126 W State St Ste 101, Boise, ID 83703-2741 2020-09-10
1144843285 Whole Health Counseling LLC Clinic/Center 2616 W Jefferson St, Boise, ID 83702-4713 2020-05-23
1033740865 Jackie Nelson, Pllc Clinic/Center 202 N 9th St Ste 401c, Boise, ID 83702-5770 2020-01-30
1437621646 Joanne Burgio Phd LLC Clinic/Center 3061 S Meridian Rd Ste 150, Meridian, ID 83642-7962 2018-12-28
1700394822 Lookout Behavioral Health LLC Clinic/Center 7905 N Meadowlark Way Ste A, Coeur D Alene, ID 83815-5041 2018-01-11
1346759495 Pacific Mind Institute Clinic/Center 2596 N Stokesberry Pl Ste 165, Meridian, ID 83646-6281 2017-09-20
1336599976 Easy Go Express Clinic/Center 3551 W Antelope Rd, Moore, ID 83255-8754 2016-06-14
1669808614 Integrated Interventions LLC Clinic/Center 2482 E. Glacier Rd., Hayden Lake, ID 83835 2013-09-23
1447695630 Susan M. Beglinger, Ltd Clinic/Center 206 E Indiana Ave, Suite 112, Coeur D Alene, ID 83814-2969 2013-05-01
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Competitor

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City RUPERT
Zip Code 83350

Improve Information

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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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