NPIMap

Organization Active NPI

JX2 LLC

Doing business as Trivium Life Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Boise, ID
National Provider Identifier
1205583127
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
JX2 LLC
Doing business as
Trivium Life Services
Practice address
8950 W Emerald St Ste 178
Boise, ID 83704-8296
Phone
(208) 376-7083
Fax
(208) 321-5069
NPI assigned
Mar 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Authorized official

Name
Heidi Williams
Title
Billing/Credentialing
Phone
(208) 376-7083

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

8950 W Emerald St Ste 178
Boise, ID 83704-8296

Mailing address

8950 W Emerald St Ste 178
Boise, ID 83704-8296
Phone (208) 376-7083

Other names 1

  • Trivium Life Services Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D1095117Trivium Life Services8950 W Emerald St #178, Boise, ID 83704Certificate of waiverFeb 2, 2027

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.

NPI Registry JSON

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

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1205583127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 W EMERALD ST STE 178",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048296",
            "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": "8950 W EMERALD ST STE 178",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048296",
            "telephone_number": "208-376-7083",
            "fax_number": "208-321-5069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JX2 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-10",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_title_or_position": "BILLING/CREDENTIALING",
        "authorized_official_telephone_number": "208-376-7083"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trivium Life Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Trivium Life Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.