NPIMap

Organization Active NPI

Idaho Dept of Health & Welfare Region 7 Amh PSR If

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Idaho Falls, ID
National Provider Identifier
1275669152
Registry record updated Aug 22, 2020
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
IDAHO DEPT OF HEALTH & WELFARE REGION 7 AMH PSR IF
Practice address
150 Shoup Ave
Suite 17
Idaho Falls, ID 83402-3657
Phone
(208) 528-5700
Fax
(208) 528-5747
NPI assigned
Feb 26, 2007
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
Mrs. Melissa M Bean, MA
Title
Program Manager
Phone
(208) 528-5706

Specialties & licenses 1

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

Addresses

Primary practice location

150 Shoup Ave
Suite 17
Idaho Falls, ID 83402-3657

Mailing address

150 Shoup Ave
Suite 17
Idaho Falls, ID 83402-3657
Phone (208) 528-5700

Other identifiers 3

IdentifierTypeStateIssuer
HW181OtherBLUE CROSS OF IDAHO
000010019479OtherBLUE SHIELD
0028410MedicaidID

National Provider Directory

National Provider Directory
Tax ID family
Reg VI Mental Health Ctr114 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

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275669152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 SHOUP AVE",
            "address_2": "SUITE 17",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023657",
            "telephone_number": "208-528-5700",
            "fax_number": "208-528-5747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SHOUP AVE",
            "address_2": "SUITE 17",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023657",
            "telephone_number": "208-528-5700",
            "fax_number": "208-528-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO DEPT OF HEALTH & WELFARE REGION 7 AMH PSR IF",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEAN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "208-528-5706",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "HW181",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010019479",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0028410",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, 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.