NPIMap

Organization Active NPI

Trivium Life Services Mountain West, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Boise, ID
National Provider Identifier
1194962829
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
TRIVIUM LIFE SERVICES MOUNTAIN WEST, LLC
Practice address
12553 W Explorer Dr Ste 190
Boise, ID 83713-1612
Phone
(208) 376-7083
Fax
(208) 321-5069
NPI assigned
Jan 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Authorized official

Name
Michelle Francesca Schaller, LMHP, LPC
Title
Senior Director of BH & RCM
Phone
(712) 355-8480

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

12553 W Explorer Dr Ste 190
Boise, ID 83713-1612

Mailing address

12553 W Explorer Dr Ste 190
Boise, ID 83713-1612
Phone (208) 376-7083

Other practice location 1

709 Dearborn St
Caldwell, ID 83605-4116
Phone (208) 376-7083

Other names 3

  • Recovery 4 Life Doing business as
  • Trivium Life Services Doing business as
  • JX2 Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100728001248 ID Part B Supplier - Clinic/Group Practice 2163555053 Receives reassigned benefits from 5 practitioners
Practice locations: Caldwell, ID; Boise, ID

National Provider Directory

National Provider Directory
Tax ID family
JX2 LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1253 N Cole Rd
Ste 100
Boise, ID 83704
Phone (208) 319-0700

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772668800000",
    "number": "1194962829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12553 W EXPLORER DR STE 190",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131612",
            "telephone_number": "208-376-7083",
            "fax_number": "208-321-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12553 W EXPLORER DR STE 190",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131612",
            "telephone_number": "208-376-7083",
            "fax_number": "208-321-5069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "709 Dearborn St",
            "address_purpose": "LOCATION",
            "city": "Caldwell",
            "state": "ID",
            "postal_code": "836054116",
            "country_code": "US",
            "telephone_number": "208-376-7083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRIVIUM LIFE SERVICES MOUNTAIN WEST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-16",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A",
        "authorized_official_last_name": "SCHALLER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "FRANCESCA",
        "authorized_official_title_or_position": "SENIOR DIRECTOR OF BH & RCM",
        "authorized_official_telephone_number": "712-355-8480",
        "authorized_official_credential": "LMHP, LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Recovery 4 Life",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Recovery 4 Life",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Trivium Life Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JX2",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; 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.

Verify at the official NPI Registry.