Human Supports of Idaho, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

HUMAN SUPPORTS OF IDAHO, INC.

Practice address

4477 W Emerald St
Ste C-100
Boise, ID 83706-2000

Phone

(208) 321-0160

Fax

(208) 321-0221

NPI assigned

Feb 14, 2007

Organization subpart

No

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

Authorized official

Name

Gregory L Dickerson, LMSW

Title

Administrator

Phone

(208) 321-0160

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Human Supports of Idaho

  • General Practice Physician
  • Caldwell, ID
  • NPI 1700129491

  O20130305000118

  Same enrollment
• Human Supports of Idaho

  • Psychiatry Physician
  • Boise, ID
  • NPI 1922340124

  O20130305000118

  Same enrollment
• Human Supports of Idaho, Inc

  • Community/Behavioral Health Agency
  • Caldwell, ID
  • NPI 1972646511

  O20130305000118

  Same enrollment

Locations

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1558404129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836060820",
            "telephone_number": "208-454-8389",
            "fax_number": "208-454-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4477 W EMERALD ST",
            "address_2": "STE C-100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837062000",
            "telephone_number": "208-321-0160",
            "fax_number": "208-321-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMAN SUPPORTS OF IDAHO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "208-321-0160",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002800000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Hulme, SLP
• Kristin K Hulquist, MPT
• Matthew Hulquist, MD
• Sara Jacobsen Hulsizer, SLP
• Human Supports of Idaho
• Human Supports of Idaho, Inc.
• Humangood Idaho (The Terraces of Boise)
• Humble Heart Counseling
• Michelle Marie Hume, LCPC
• Hummingbird Ventures, LLC

• Community/Behavioral Health Agency in Boise, ID
• Providers in Boise, ID by specialty
• Community/Behavioral Health Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; 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.