Metamorphosis Health, Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

METAMORPHOSIS HEALTH, INC

Practice address

10108 W Overland Rd Ste a
Boise, ID 83709-1428

Phone

(208) 376-1532

Fax

(208) 375-7251

NPI assigned

Oct 18, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Crystal Michelle Miller

Title

Ceo/Owner

Phone

(208) 890-6205

Specialties & licenses 7

Addresses

Tax ID family

Metamorphosis Health Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Metamorphosis Health, Inc

  • Case Manager/Care Coordinator
  • Boise, ID
  • NPI 1720856248
  NPD tax ID
• Metamorphosis Health, Inc.

  • Peer Specialist
  • Boise, ID
  • NPI 1457129975
  NPD tax ID
• Metamorphosis Health, Inc.

  • Community/Behavioral Health Agency
  • Boise, ID
  • NPI 1548038060
  NPD tax ID

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

{
    "created_epoch": "1697587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1407638992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2118 N AZURITE DR",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836344904",
            "telephone_number": "208-376-1532",
            "fax_number": "208-375-7251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10108 W OVERLAND RD STE A",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091428",
            "telephone_number": "208-376-1532",
            "fax_number": "208-375-7251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METAMORPHOSIS HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-18",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "208-890-6205",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Metamorphosis Counseling and Health Center of Idaho, LLC
• Metamorphosis Counseling and Health Center of Idaho, LLC
• Metamorphosis Counseling and Health Center of Idaho, LLC
• Metamorphosis Counseling and Health Center of Idaho, LLC
• Metamorphosis Counseling and Health Center of Idaho, LLC
• Metamorphosis Health, Inc
• Metamorphosis Health, Inc.
• Metamorphosis Health, Inc.
• Carly Ruth Metcalf, RD, LD
• Methodist Counseling Center Inc

• Multi-Specialty Clinic/Center in Boise, ID
• Providers in Boise, ID by specialty
• Multi-Specialty Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.