CENTER FOR BEHAVIORAL HEALTH IDAHO, INC. (NPI# 1629223128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629223128 |
| Entity Type | Organization |
| Organization Name | CENTER FOR BEHAVIORAL HEALTH IDAHO, INC. |
| Practice Address |
1965 S Eagle Rd Suite 180 Meridian ID 83642-9288 |
| Mailing Address |
Po Box 897 Boise ID 83701-0897 |
| Practice Telephone | 2082880649 |
| Practice Fax Number | 2082880651 |
| Enumeration Date | 2008-11-25 |
| Last Update Date | 2008-11-25 |
| Authorized Official Name | BRANT MASSMAN (SEC./TREAS.) |
| Authorized Official Telephone | 2083679446 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811421548 | Center for Behavioral Health Idaho, Inc. | Clinic/Center | 2275 S Eagle Rd, Suite 190, Meridian, ID 83642-5079 | 2017-04-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CENTER FOR BEHAVIORAL HEALTH IDAHO, INC. | 92 S Cole Rd, Boise, ID 83709-0930 |
| Street Address |
1965 S EAGLE RD SUITE 180 |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-9288 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003963638 | Gary W Lee | Social Worker | 1965 S Eagle Rd, Ste 140, Meridian, ID 83642-9288 | 2007-01-04 |
| 1376098533 | Zelus Recovery LLC | Community/Behavioral Health | 1965 S Eagle Rd, Suite 140, Meridian, ID 83642-9288 | 2016-08-17 |
| 1184842346 | Jason Paul Zelus | Social Worker | 1965 S Eagle Rd, Suite 140, Meridian, ID 83642-9288 | 2007-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| 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 |
|---|---|---|---|---|
| 1376196246 | Tina M Thomas | Community/Behavioral Health | 3800 W Perugia St Apt W204, Meridian, ID 83642-4973 | 2019-07-19 |
| 1023483211 | The Family Table, Inc. | Community/Behavioral Health | 1005 E Franklin Rd, Meridian, ID 83642-5951 | 2015-12-14 |
| 1972987543 | Maitri Community Services | Community/Behavioral Health | 3709 N Locust Grove Rd, Suite 100, Meridian, ID 83646-6449 | 2015-07-14 |
| 1417210154 | Langston Jett Enterprises, LLC | Community/Behavioral Health | 3512 36th Ave, Meridian, MS 39307-3603 | 2012-06-18 |
| 1689989816 | Preferred Community Homes, LLC | Community/Behavioral Health | 440 W Pennwood St Ste 200, Meridian, ID 83642-8602 | 2010-08-12 |
| 1619293222 | Access Living | Community/Behavioral Health | 690 S Industry Way Ste 45, Meridian, ID 83642-7907 | 2010-04-08 |
| 1992035364 | Mountain View Behavioral Health, Pllc | Community/Behavioral Health | 3138 W Mirage Ct, Meridian, ID 83646-4127 | 2010-01-07 |
| 1316272248 | Journey Mental Health | Community/Behavioral Health | 2525 N Stokesberry Pl Ste A, Meridian, ID 83646-1144 | 2009-10-09 |
| 1912136466 | Adams Center for Counseling LLC | Community/Behavioral Health | 2525 N Stokesberry Pl, Suite A, Meridian, ID 83646-1502 | 2009-07-06 |
| 1851413314 | Inroads Inc. | Community/Behavioral Health | 3288 E Pine Ave, Meridian, ID 83642 | 2007-04-04 |
| Find all providers in MERIDIAN | ||||
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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.