NPIMap

Organization Active NPI

Idaho Dept of Health & Welfare CMH Clinic Boise

  • Adolescent and Children Mental Health Clinic/Center
  • Boise, ID
National Provider Identifier
1205966249
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
IDAHO DEPT OF HEALTH & WELFARE CMH CLINIC BOISE
Practice address
1720 Westgate Dr
Suite D
Boise, ID 83704-7164
Phone
(208) 334-0792
Fax
(208) 334-0812
NPI assigned
Mar 7, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gina Westcott, M.A,
Title
Program Manager
Phone
(208) 334-0969

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

1720 Westgate Dr
Suite D
Boise, ID 83704-7164

Mailing address

1720 Westgate Dr
Suite D
Boise, ID 83704-7164
Phone (208) 334-0792

Other identifiers 3

IdentifierTypeStateIssuer
HW090OtherBLUE CROSS OF IDAHO
000010019129OtherBLUE SHIELD
8075988MedicaidID

National Provider Directory

National Provider Directory
Tax ID family
State of Idaho Dept Health114 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1720 N Westgate Dr
#D
Boise, ID 83704
Phone (208) 334-0792

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205966249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 WESTGATE DR",
            "address_2": "SUITE D",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837047164",
            "telephone_number": "208-334-0792",
            "fax_number": "208-334-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 WESTGATE DR",
            "address_2": "SUITE D",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837047164",
            "telephone_number": "208-334-0792",
            "fax_number": "208-334-0812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO DEPT OF HEALTH & WELFARE CMH CLINIC BOISE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WESTCOTT",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "208-334-0969",
        "authorized_official_credential": "M.A,"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "HW090",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010019129",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8075988",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.