NPIMap

Organization Active NPI

Idaho Dept of Health & Welfare Reg 7 CMH P C

  • Rehabilitation Clinic/Center
  • Blackfoot, ID
National Provider Identifier
1639201593
Registry record updated Aug 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
IDAHO DEPT OF HEALTH & WELFARE REG 7 CMH P C
Practice address
720 E Alice
Blackfoot, ID 83221-0129
Phone
(208) 785-5871
Fax
(208) 785-5877
NPI assigned
Mar 9, 2007
Last updated
Aug 10, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2010

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

Authorized official

Name
Randy Rodriquez, LCSWNPI 1932660289
Title
Program Manager
Phone
(208) 528-5700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

720 E Alice
Blackfoot, ID 83221-0129

Mailing address

720 E Alice PO Box 129
Blackfoot, ID 83221-0129
Phone (208) 785-5871

National Provider Directory

National Provider Directory
Tax ID family
Idaho Dept of Health Welfare Amh PSR Boise114 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

Locations

720 E Alice
Blackfoot, ID 83221
Phone (208) 785-5871

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281398400000",
    "number": "1639201593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 E ALICE PO BOX 129",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832210129",
            "telephone_number": "208-785-5871",
            "fax_number": "208-785-5877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 E ALICE",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832210129",
            "telephone_number": "208-785-5871",
            "fax_number": "208-785-5877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO DEPT OF HEALTH & WELFARE REG 7 CMH P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2010-08-10",
        "status": "A",
        "authorized_official_last_name": "RODRIQUEZ",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "208-528-5700",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blackfoot, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; 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.