Mountain River Mental Health

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

MOUNTAIN RIVER MENTAL HEALTH

Practice address

3767 Professional Way
Idaho Falls, ID 83402-7315

Phone

(208) 522-8899

Fax

(208) 522-6596

NPI assigned

Mar 11, 2007

Organization subpart

No

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

Authorized official

Name

Bruce Hampton, MSW

Title

President Social Worker

Phone

(208) 522-8899

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Mountain River Mental Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Mountain River Mental Health

  • Social Worker
  • Idaho Falls, ID
  • NPI 1073771143
  NPD tax ID

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

{
    "created_epoch": "1173571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1447382973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2106",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834032106",
            "telephone_number": "208-522-8899",
            "fax_number": "208-522-6596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3767 PROFESSIONAL WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834027315",
            "telephone_number": "208-522-8899",
            "fax_number": "208-522-6596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN RIVER MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-11",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "HAMPTON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT SOCIAL WORKER",
        "authorized_official_telephone_number": "208-522-8899",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806612700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mountain Care Pharmacy Idaho
• Mountain Crest Foot and Ankle PA
• Mountain Falls Medical LLC
• Mountain Falls Quick Care
• Mountain River Mental Health
• Mountain States Cardiovascular and
• Mountain States Diabetes Relief, LLC
• Mountain View Hospital LLC
• Mountain View Hospital LLC
• Mountain View Hospital Physician Organization

• Social Worker in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.