CHILDRENS SUPPORTIVE SERVICES INCORPORATED (NPI# 1407074636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407074636 |
| Entity Type | Organization |
| Organization Name | CHILDRENS SUPPORTIVE SERVICES INCORPORATED |
| Practice Address |
625 W Pacific St Suite 2 Blackfoot ID 83221-2034 |
| Mailing Address |
1565 E Lincoln Rd Idaho Falls ID 83401-2129 |
| Practice Telephone | 2085248996 |
| Practice Fax Number | 2085241205 |
| Mailing Telephone | 2085248996 |
| Mailing Fax Number | 2085241205 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2009-12-02 |
| Authorized Official Name | CATHIE CRANE (SECRETARY-TREASURER) |
| Authorized Official Telephone | 2085248996 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 807354200 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790903920 | Childrens Supportive Services Incorporated | Community/Behavioral Health | 1600 E Lincoln Rd, Idaho Falls, ID 83401-2144 | 2007-04-23 |
| 1558429977 | Childrens Supportive Services Incorporated | Community/Behavioral Health | 1565 E Lincoln Rd, Idaho Falls, ID 83401-2129 | 2006-12-05 |
| 1023236254 | Childrens Supportive Services Incorporated | Community/Behavioral Health | 1565 E Lincoln Rd, Idaho Falls, ID 83401-2129 | 2007-04-23 |
| 1932327160 | Childrens Supportive Services Incorporated | Community/Behavioral Health | 224 Evans Ln, Chubbuck, ID 83202-1912 | 2007-04-23 |
| 1003034224 | Childrens Supportive Services Incorporated | Case Management | 1600 E Lincoln Rd, Idaho Falls, ID 83401-2144 | 2007-04-23 |
| 1467679035 | Childrens Supportive Services Incorporated | Community/Behavioral Health | 625 W Pacific St, Suite 2, Blackfoot, ID 83221-2034 | 2007-04-18 |
| 1306063987 | Childrens Supportive Services Incorporated | Community/Behavioral Health | 224 Evans Ln, Chubbuck, ID 83202-1912 | 2007-04-18 |
| Street Address |
625 W PACIFIC ST SUITE 2 |
| City | BLACKFOOT |
| State | ID |
| Zip Code | 83221-2034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356416861 | Community Council of Idaho, Inc. | Family Medicine | 625 W Pacific St, Suite 3, Blackfoot, ID 83221-2034 | 2006-11-21 |
| 1588837496 | Damon T. Armstrong D.d.s., P.c | Dentist | 625 W Pacific St, Suite #4, Blackfoot, ID 83221-2034 | 2008-04-11 |
| 1467679035 | Childrens Supportive Services Incorporated | Community/Behavioral Health | 625 W Pacific St, Suite 2, Blackfoot, ID 83221-2034 | 2007-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932711165 | Samantha Paige Averett | Social Worker | 60 N Broadway, Blackfoot, ID 83221 | 2020-08-19 |
| 1730711656 | Sara Marie Letham | Family Medicine | 33 S Thompson Lane, Blackfoot, ID 83221 | 2020-02-08 |
| 1962994962 | Tyler Thomas Wood | Student in an Organized Health Care Education/Training Program | 98 Poplar Street, Blackfoot, Id 83221, Blackfoot, ID 83221 | 2018-06-05 |
| 1801336276 | Bmh, Inc. | Internal Medicine | 235 Poplar St, Blackfoot, ID 83221 | 2017-03-03 |
| 1497119804 | Susan Doran | Social Worker | 720 E. Alice, Blackfoot, ID 83221 | 2016-04-12 |
| 1427412121 | Josie Russell Adkins | Counselor | 720 East Alice, Blackfoot, ID 83221 | 2016-04-08 |
| 1740590314 | Ashley Nichole Thomas | Physician Assistant | 710 E. Alice Street, Blackfoot, ID 83221 | 2010-10-18 |
| 1528373313 | Stephanie Lynn Henderson | Dietitian, Registered | 1555 Vernon Ave, Blackfoot, ID 83221 | 2010-08-17 |
| 1184850141 | Joy H. Taylor | Nurse Practitioner | 1441 Parkway Drive, Blackfoot, ID 83221 | 2009-06-04 |
| 1427232925 | Nathan E. Sneddon | Anesthesiology | 98 Poplar St Fl 3, Blackfoot, ID 83221 | 2007-12-20 |
| Find all providers in zip 83221 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538352828 | Awareness Center for Counseling | Community/Behavioral Health | 167 W Bridge St, Blackfoot, ID 83221-2704 | 2007-08-21 |
| 1366593964 | A To Z Family Services Inc. | Community/Behavioral Health | 150 S Broadway St, Blackfoot, ID 83221-2711 | 2007-01-12 |
| 1316000441 | The Living Farm, PC | Community/Behavioral Health | 373 W Highway 39 # 2, Blackfoot, ID 83221-5600 | 2006-12-19 |
| 1568006815 | Stillwaters Counseling LLC | Community/Behavioral Health | 1309 Camas St, Blackfoot, ID 83221-3060 | 2019-10-30 |
| 1780879700 | Southeastern Idaho Developmental Center, Inc. | Community/Behavioral Health | 765 W Judicial St, Blackfoot, ID 83221-2036 | 2007-09-12 |
| 1609094929 | A To Z Family Services Inc. | Community/Behavioral Health | 150 S Broadway St, Blackfoot, ID 83221-2711 | 2007-04-23 |
| 1104042944 | A To Z Family Services Inc. | Community/Behavioral Health | 150 S Broadway St, Blackfoot, ID 83221-2711 | 2007-04-18 |
| 1831315670 | A To Z Family Services Inc. | Community/Behavioral Health | 150 S Broadway St, Blackfoot, ID 83221-2711 | 2007-04-18 |
| 1336365097 | Family Pathways Cooperative, Inc | Community/Behavioral Health | 75 Lilac St, Blackfoot, ID 83221-1768 | 2007-04-18 |
| 1467679035 | Childrens Supportive Services Incorporated | Community/Behavioral Health | 625 W Pacific St, Suite 2, Blackfoot, ID 83221-2034 | 2007-04-18 |
| Find all providers in BLACKFOOT | ||||
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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.