NPIMap

Organization Active NPI

Idaho Dept of Health & Welfare Reg 1 Amh

  • Adult Mental Health Clinic/Center
  • Kellogg, ID
National Provider Identifier
1447557772
Registry record updated Feb 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
IDAHO DEPT OF HEALTH & WELFARE REG 1 AMH
Practice address
35 Wildcat Way
Kellogg, ID 83837-2261
Phone
(208) 784-1351
Fax
(208) 784-1356
NPI assigned
Feb 23, 2011
Last updated
Feb 23, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2011

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

Authorized official

Name
Vicki Malone
Title
Program Manager
Phone
(208) 769-1406

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

35 Wildcat Way
Kellogg, ID 83837-2261

Mailing address

35 Wildcat Way
Kellogg, ID 83837-2261
Phone (208) 784-1351

Other identifiers 2

IdentifierTypeStateIssuer
000010018348OtherIDBLUE SHIELD
HW256OtherIDBLUE CROSS

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

NPI Registry JSON

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

{
    "created_epoch": "1298419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298419200000",
    "number": "1447557772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 WILDCAT WAY",
            "city": "KELLOGG",
            "state": "ID",
            "postal_code": "838372261",
            "telephone_number": "208-784-1351",
            "fax_number": "208-784-1356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 WILDCAT WAY",
            "city": "KELLOGG",
            "state": "ID",
            "postal_code": "838372261",
            "telephone_number": "208-784-1351",
            "fax_number": "208-784-1356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO DEPT OF HEALTH & WELFARE REG 1 AMH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-23",
        "last_updated": "2011-02-23",
        "status": "A",
        "authorized_official_last_name": "MALONE",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "208-769-1406"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010018348",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "HW256",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kellogg, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2011; 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.