IDAHO DEPT OF HEALTH & WELFARE REG 6 AMH PSR PRES (NPI# 1275664583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275664583 |
| Entity Type | Organization |
| Organization Name | IDAHO DEPT OF HEALTH & WELFARE REG 6 AMH PSR PRES |
| Practice Address |
223 N State St Preston ID 83263-1140 |
| Mailing Address |
421 Memorial Dr Pocatello ID 83201-4008 |
| Practice Telephone | 2088520634 |
| Practice Fax Number | 2088522136 |
| Mailing Telephone | 2082347900 |
| Mailing Fax Number | 2082366328 |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ED AXFORD II (PROGRAM MANAGER) |
| Authorized Official Telephone | 2082347900 |
| 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 |
|---|---|---|---|
| ID | BLUE CROSS OF IDAHO | HW108 | 01 |
| ID | BLUE SHIELD | 000010019235 | 01 |
| ID | 8073684 | 05 |
| Street Address |
223 N STATE ST |
| City | PRESTON |
| State | ID |
| Zip Code | 83263-1140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447735493 | Marie Luke | Massage Therapist | 8 South State, Preston, ID 83263 | 2018-09-26 |
| 1881945921 | Michael David Earley | Chiropractor | 645 N State St, Preston, ID 83263 | 2012-09-28 |
| 1184872632 | Joel Thomas Webb | Physician Assistant | 47 N 1st E, Preston, ID 83263 | 2008-09-08 |
| 1245490390 | Daniel Yugi Patten | Family Medicine | 47 N. 1st E., Preston, ID 83263 | 2008-06-12 |
| 1144313610 | Tifani Waechtler | Physical Therapist | 43 North 100 East, Preston, ID 83263 | 2006-10-02 |
| 1215035969 | Larry's Family Pharmacy, Inc. | Pharmacist | 217 South State St., Preston, ID 83263 | 2006-09-20 |
| 1801909122 | David Bradley Beckstead | Family Medicine | 41 North 1 East, Preston, ID 83263 | 2006-08-17 |
| 1922022482 | Alan D Holt | Nurse Anesthetist, Certified Registered | 44 North 100 East, Preston, ID 83263 | 2006-07-27 |
| 1780979914 | Stuart G Knapp | Family Medicine | 47 N 1st E, Preston, ID 83263 | 2011-06-15 |
| 1104135326 | Chantee I Wyatt | Physician Assistant | 47 N 1st E, Preston, ID 83263 | 2010-10-05 |
| Find all providers in zip 83263 | ||||
| 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 |
|---|---|---|---|---|
| 1598364978 | Brave Ahead Counseling | Clinic/Center | 991 Sunset Rd, Athol, ID 83801-9287 | 2020-10-18 |
| 1356959191 | Healing Minds LLC | Clinic/Center | 6586 W Flagstaff St, Rathdrum, ID 83858-8203 | 2020-07-17 |
| 1487273637 | Answers, LLC - Cbrs | Clinic/Center | 855 N Capital Ave Ste 1, Idaho Falls, ID 83402-3405 | 2020-04-08 |
| 1649808767 | Psychological Preventative Health Pllc | Clinic/Center | 4831 Greystone Ln, Idaho Falls, ID 83404-8338 | 2020-04-01 |
| 1073148623 | Begin Within Counseling, LLC | Clinic/Center | 943 W Overland Rd Ste 111, Meridian, ID 83642-6541 | 2020-03-04 |
| 1871126797 | Avanzar Wellness LLC | Clinic/Center | 11513 W Fairview Ave Ste 105, Boise, ID 83713-7887 | 2020-02-19 |
| 1174155741 | Noble Intent | Clinic/Center | 1406 N Main St Ste 204, Meridian, ID 83642-1746 | 2020-02-11 |
| 1194362517 | Advanced Counseling LLC | Clinic/Center | 39 W Pine Ave, Meridian, ID 83642-2281 | 2019-12-04 |
| 1629615406 | Building A Life Worth Living, LLC | Clinic/Center | 771 S Woodruff Ave, Idaho Falls, ID 83401-5286 | 2019-11-29 |
| 1750927281 | Weme Counseling and Clinical Consultation | Clinic/Center | 231 N Third Ave Ste 207, Sandpoint, ID 83864-1418 | 2019-11-19 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on IDAHO DEPT OF HEALTH & WELFARE REG 6 AMH PSR PRES.
| 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.