NPIMap

Organization Active NPI

Mountain States Chemical Dependency and Counseling Services, Inc.

  • Community/Behavioral Health Agency
  • Nampa, ID
National Provider Identifier
1043368418
Registry record updated Jun 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MOUNTAIN STATES CHEMICAL DEPENDENCY AND COUNSELING SERVICES, INC.
Practice address
1305 2ND St S
Suite 201
Nampa, ID 83651-3944
Phone
(208) 463-0202
Fax
(208) 463-0205
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Rusty O'Leary, LCPC
Title
Executive Director
Phone
(208) 463-0202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1305 2ND St S
Suite 201
Nampa, ID 83651-3944

Mailing address

1305 2ND St South
Suite 201
Nampa, ID 83651-3964
Phone (208) 463-0202

Other identifiers 3

IdentifierTypeStateIssuer
806878800MedicaidID
806892300MedicaidID
807126800MedicaidID

Other names 1

  • Valley View Mental Health Other name

National Provider Directory

National Provider Directory

Locations

1305 2nd St S
Ste 201
Nampa, ID 83651
Phone (208) 463-0202

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372118400000",
    "number": "1043368418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 2ND ST SOUTH",
            "address_2": "SUITE 201",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513964",
            "telephone_number": "208-463-0202",
            "fax_number": "208-463-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 2ND ST S",
            "address_2": "SUITE 201",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513944",
            "telephone_number": "208-463-0202",
            "fax_number": "208-463-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN STATES CHEMICAL DEPENDENCY AND COUNSELING SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2013-06-25",
        "status": "A",
        "authorized_official_last_name": "O'LEARY",
        "authorized_official_first_name": "RUSTY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "208-463-0202",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806878800",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806892300",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807126800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley View Mental Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.