IDAHO DEPT OF HEALTH & WELFARE REG 6 CMH BF C


Address: 701 E Alice, Blackfoot, ID 83221-0129
Phone: 2087855826

IDAHO DEPT OF HEALTH & WELFARE REG 6 CMH BF C (NPI# 1710019476) 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) 1710019476
Entity Type Organization
Organization Name IDAHO DEPT OF HEALTH & WELFARE REG 6 CMH BF C
Practice Address 701 E Alice
Blackfoot
ID 83221-0129
Mailing Address Po Box 129
Blackfoot
ID 83221-0129
Practice Telephone 2087855826
Practice Fax Number 2087851003
Mailing Telephone 2087855826
Mailing Fax Number 2087851003
Enumeration Date 2007-03-09
Last Update Date 2020-08-22
Authorized Official Name ED AXFORD (PROGRAM MANAGER)
Authorized Official Telephone 2082347900
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM0855X Clinic/Center
Specialization: Adolescent and Children Mental Health
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
ID BLUE SHIELD 000010019402 01
ID 8073650 05
ID BLUE CROSS HW157 01

Office Location

Street Address 701 E ALICE
City BLACKFOOT
State ID
Zip Code 83221-0129

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 261QM0855X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Adolescent and Children 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 children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
Notes: [7/1/2003: new]

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1508405945 Nate Bonovitz Counseling, LLC Clinic/Center 1151 E Iron Eagle Dr, Eagle, ID 83616-6854 2020-01-02
1720620750 Jim Smidt Clinic/Center 820 N William St, Post Falls, ID 83854-5123 2019-10-10
1225507668 Summus Counseling, LLC Clinic/Center 211 S Woodruff Ave Ste 13, Idaho Falls, ID 83401-4324 2018-11-14
1750705687 Answers, LLC Clinic/Center 527 W 20th St, Idaho Falls, ID 83402-4421 2014-02-12
1124372370 A Plus Solutions Center Clinic/Center 2311 Parke Ave. Unit 3, Suite 12, Burley, ID 83318 2012-11-08
1598012700 Tueller Counseling Services Clinic/Center 2275 West Broadway Suite G, Idaho Falls, ID 83402 2012-08-07
1952674988 My Brother's Keeper Mbk Clinic/Center 704 S Cole Rd, Boise, ID 83709-1861 2012-02-22
1639476294 Idaho Dept of Health & Welfare Reg 2 Cmh Clinic/Center 1350 Troy Highway, Moscow, ID 83843-3995 2011-02-17
1154639714 Eartherapy Clinic/Center 354 W Sunnyside Rd, Suite D, Idaho Falls, ID 83402-4644 2010-09-16
1104048503 Community Partnerships of Idaho, Inc. Clinic/Center 3214 N Acre Ln, Boise, ID 83704-4501 2007-05-03
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Competitor

Search similar providers

City BLACKFOOT
Zip Code 83221

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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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