Active NPI
Allied Mental Health Services, P.L.L.C.
- Community/Behavioral Health Agency
- Star, ID
National Provider Identifier
1104011337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- ALLIED MENTAL HEALTH SERVICES, P.L.L.C.
- Practice address
- 11104 W. State St.
Star, ID 83669 - Phone
- (208) 286-7967
- Fax
- (208) 286-9047
- NPI assigned
- Sep 11, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Cory L. Thacker, M.S.
- Title
- President/Owner
- Phone
- (208) 286-7967
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
11104 W. State St.
Star, ID 83669
Mailing address
PO Box 545
Star, ID 83669-0545
Phone (208) 286-7967
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240918000957 | ID | Part B Supplier - Clinic/Group Practice | 9234670241 |
Receives reassigned benefits from 1 practitioner Practice locations: Nampa, ID |
National Provider Directory
National Provider Directory- Tax ID family
- Allied Mental Health Services PLLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Case Management Agency
- Star, ID
- NPI 1659566727
-
- Community/Behavioral Health Agency
- Star, ID
- NPI 1780826594
Locations
220 10th Ave S
Nampa, ID 83651
Phone (208) 468-0850
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189468800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1189468800000",
"number": "1104011337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 545",
"city": "STAR",
"state": "ID",
"postal_code": "836690545",
"telephone_number": "208-286-7967",
"fax_number": "208-286-9047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11104 W. STATE ST.",
"city": "STAR",
"state": "ID",
"postal_code": "83669",
"telephone_number": "208-286-7967",
"fax_number": "208-286-9047"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALLIED MENTAL HEALTH SERVICES, P.L.L.C.",
"organizational_subpart": "NO",
"enumeration_date": "2007-09-11",
"last_updated": "2007-09-11",
"status": "A",
"authorized_official_last_name": "THACKER",
"authorized_official_first_name": "CORY",
"authorized_official_middle_name": "L.",
"authorized_official_title_or_position": "PRESIDENT/OWNER",
"authorized_official_telephone_number": "208-286-7967",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "M.S."
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Star, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.