NPIMap

Organization Active NPI

Living Hope Clinic Inc

  • Mental Health Counselor
  • Boise, ID
National Provider Identifier
1306901749
Registry record updated Aug 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LIVING HOPE CLINIC INC
Practice address
3308 N Cole Rd
Suite a
Boise, ID 83704-4403
Phone
(208) 378-1122
NPI assigned
Dec 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2007

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

Authorized official

Name
Charles M Rice, PH.DNPI 1336176171
Title
Owner
Phone
(208) 378-1122

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

3308 N Cole Rd
Suite a
Boise, ID 83704-4403

Mailing address

3308 N Cole Rd
Suite a
Boise, ID 83704-4403
Phone (208) 378-1122

Other identifiers 1

IdentifierTypeStateIssuer
N9212OtherIDBLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071127000176 ID Part B Supplier - Clinic/Group Practice 1254432974 Receives reassigned benefits from 1 practitioner
Practice locations: Boise, ID

National Provider Directory

National Provider Directory

Locations

3308 N Cole Rd
Ste A
Boise, ID 83704
Phone (208) 378-1122

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186963200000",
    "number": "1306901749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3308 N COLE RD",
            "address_2": "SUITE A",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044403",
            "telephone_number": "208-378-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3308 N COLE RD",
            "address_2": "SUITE A",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044403",
            "telephone_number": "208-378-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING HOPE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-08-13",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-378-1122",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "N9212",
            "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 13, 2007; 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.