STATE OF IDAHO DEPARTMENT OF HEALTH AND WELFARE (NPI# 1992789101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992789101 |
| Entity Type | Organization |
| Organization Name | STATE OF IDAHO DEPARTMENT OF HEALTH AND WELFARE |
| Other Organization Name | STATE HOSPITAL SOUTH |
| Practice Address |
700 East Alice Box 400 Blackfoot ID 83221 |
| Mailing Address |
700 E Alice St Po Box 400 Blackfoot ID 83221-4925 |
| Practice Telephone | 2087851200 |
| Practice Fax Number | 2087858518 |
| Mailing Telephone | 2087851200 |
| Mailing Fax Number | 2087858518 |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2013-05-08 |
| Authorized Official Name | MRS. TRACEY G. SESSIONS (HOSPITAL ADMINISTRATOR) |
| Authorized Official Telephone | 2087858402 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283Q00000X | Psychiatric Hospital | #17 | ID | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE CROSS OF IDAHO | 00844 | 01 |
| ID | REGENCE BLUE SHIELD OF ID | 20315 | 01 |
| ID | 002821500 | 05 |
| Other Name | Type Code |
|---|---|
| State Hospital South | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538225545 | State of Idaho Department of Health and Welfare | Clinic/Center | 700 E. Alice, Box 400, Blackfoot, ID 83221-0400 | 2006-12-28 |
| 1609267715 | State of Idaho Department of Health and Welfare | Psychologist | 700 East Alice, Blackfoot, ID 83221 | 2015-02-11 |
| 1518022342 | State of Idaho Department of Health and Welfare | Skilled Nursing Facility | 700 E Alice St, Box 400, Blackfoot, ID 83221-4925 | 2006-12-22 |
| Street Address |
700 EAST ALICE BOX 400 |
| City | BLACKFOOT |
| State | ID |
| Zip Code | 83221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609267715 | State of Idaho Department of Health and Welfare | Psychologist | 700 East Alice, Blackfoot, ID 83221 | 2015-02-11 |
| 1013132471 | Daniel Bart Harrison | Pharmacist | 700 East Alice, Blackfoot, ID 83221 | 2007-04-13 |
| 1790837292 | Chris C Lemon | Pharmacist | 700 East Alice, State Hospital South, Blackfoot, ID 83221-0400 | 2007-01-17 |
| 1790841781 | State of Idaho | Clinical Medical Laboratory | 700 East Alice, Blackfoot, ID 83221 | 2006-12-28 |
| 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 | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619360724 | Charolais Care Viii, Inc | Psychiatric Hospital | 650 Addison Ave W Ste 300b, Twin Falls, ID 83301-5851 | 2015-03-13 |
| 1710072046 | Helping Hands Sanctuary of Idaho | Psychiatric Hospital | 500 Polk St E, Kimberly, ID 83341 | 2006-10-03 |
| 1275504896 | Beacon Health Services Inc | Psychiatric Hospital | 1200 Hospital Way, Pocatello, ID 83201-2708 | 2006-01-31 |
| 1437620358 | Lifeways, Inc | Psychiatric Hospital | 8050 W Northview St, Boise, ID 83704-7126 | 2018-12-17 |
| 1003397878 | Hbs of Meridian, LLC | Psychiatric Hospital | 2131 S Bonito Way, Meridian, ID 83642-1659 | 2018-08-28 |
| 1770977787 | Concordia Health Care Inc | Psychiatric Hospital | 1200 Hospital Way, Pocatello, ID 83201-2708 | 2015-03-27 |
| 1942643432 | Safe Haven Health Care Inc | Psychiatric Hospital | 8050 W Northview St, Boise, ID 83704-7126 | 2013-04-15 |
| 1780937532 | Dustin Sharpe | Psychiatric Hospital | 8050 W Northview St, Boise, ID 83704-7126 | 2012-10-17 |
| 1871800128 | Mountain View Center for Geriatric Psychiatry LLC | Psychiatric Hospital | 500 Polk St E, Kimberly, ID 83341-1618 | 2010-09-08 |
| 1619208709 | Safe Haven Health Care LLC | Psychiatric Hospital | 1200 Hospital Way, Pocatello, ID 83201-2708 | 2010-01-29 |
| Find all providers with the same taxonomy | ||||
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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.