Affirm Human Services

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

AFFIRM HUMAN SERVICES

Practice address

2743 E Iona Rd
Idaho Falls, ID 83401-1343

Phone

(208) 520-2929

NPI assigned

Jan 4, 2023

Organization subpart

No

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

Authorized official

Name

Angel L Johnson

Title

Chief Admin Officer

Phone

(208) 520-2929

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1154034189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2743 E IONA RD",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834011343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2743 E IONA RD",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834011343",
            "telephone_number": "208-520-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFIRM HUMAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-04",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF ADMIN OFFICER",
        "authorized_official_telephone_number": "208-520-2929"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "11481887",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11481887",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Idaho Falls, ID
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; 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.