APEX ADVENTURE THERAPY (NPI# 1376935494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376935494 |
| Entity Type | Organization |
| Organization Name | APEX ADVENTURE THERAPY |
| Other Organization Name | BLUEFIRE WILDERNESS THERAPY |
| Practice Address |
1832 E 1750 S Gooding ID 83330-5177 |
| Practice Telephone | 2089344444 |
| Practice Fax Number | 2089345171 |
| Mailing Telephone | 2089344444 |
| Mailing Fax Number | 2089345171 |
| Enumeration Date | 2015-02-26 |
| Last Update Date | 2016-08-09 |
| Authorized Official Name | MS. KATHY REX (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2083083163 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 38122 | ID | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| BlueFire Wilderness Therapy | Doing Business As Name - Organization |
| Street Address |
1832 E 1750 S |
| City | GOODING |
| State | ID |
| Zip Code | 83330-5177 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871115717 | Megan George | Counselor | 1832 E 1750 S, Gooding, ID 83330 | 2020-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346648227 | Erin Orloff | Speech-Language Pathologist | 202 14th St Ave E, Gooding, ID 83330 | 2014-12-09 |
| 1518377019 | North Canyon Medical Center, Inc. | Clinic/Center | 267 N. Canyon Drive, Gooding, ID 83330 | 2014-05-06 |
| 1083959332 | Lydia Jo Missal | Counselor | 1832 E. 1750 S., Gooding, ID 83330 | 2012-11-27 |
| 1013240910 | Marcella Louise Heil | Speech-Language Pathologist | 1735 South 1800 East, Gooding, ID 83330 | 2009-09-09 |
| 1861561094 | Thomas Ernest Pryor | Family Medicine | 121 5th Ave West, Gooding, ID 83330 | 2006-11-06 |
| 1942212600 | Marcy Lin Morrow | Physician Assistant | 134 4th Ave W, Gooding Family Physicians, Gooding, ID 83330 | 2006-08-12 |
| 1174535835 | Ian B Kunz | Physician Assistant | 267 N Canyon Drive, Gooding, ID 83330 | 2006-08-12 |
| 1326002650 | Associates In Family Practice Pa | Family Medicine | 425 Idaho St, Gooding, ID 83330 | 2006-04-13 |
| 1497719728 | Mark D Spencer | Family Medicine | 425 Idaho Street, Gooding, ID 83330 | 2006-04-13 |
| 1982173746 | Tdc Gooding Pllc | Dentist | 325 Main Street, Gooding, ID 83330 | 2018-11-21 |
| Find all providers in zip 83330 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952738262 | Idaho Youth Ranch | Residential Treatment Facility, Emotionally Disturbed Children | 5465 W Irving St, Boise, ID 83706-1213 | 2013-10-01 |
| 1568758720 | Daybreak Canyon LLC | Residential Treatment Facility, Emotionally Disturbed Children | 1229 Country Club Rd., Kellogg, ID 83837 | 2011-06-24 |
| 1073843868 | Sequel Tsi of Idaho, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2850 Industrial Way, Mountain Home, ID 83647-3960 | 2009-12-30 |
| 1619119864 | Ahs of Idaho | Residential Treatment Facility, Emotionally Disturbed Children | 911 Preacher Creek Rd, Shoshone, ID 83352-5061 | 2009-04-02 |
| 1235758897 | Hawks Landing of Idaho LLC | Residential Treatment Facility, Emotionally Disturbed Children | 222 Nighthawk Rd, Bonners Ferry, ID 83805-5441 | 2020-04-14 |
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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.