NPIMap

Organization Active NPI

Idaho Dept of Health & Welfare Reg 2 CMH

  • Adolescent and Children Mental Health Clinic/Center
  • Moscow, ID
National Provider Identifier
1639476294
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
IDAHO DEPT OF HEALTH & WELFARE REG 2 CMH
Practice address
1350 Troy Highway
Moscow, ID 83843-3995
Phone
(208) 882-0562
NPI assigned
Feb 17, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 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) 799-4440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

1350 Troy Highway
Moscow, ID 83843-3995

Mailing address

1350 Troy Highway
Moscow, ID 83843-3995
Phone (208) 882-0562

Other identifiers 2

IdentifierTypeStateIssuer
000010018450OtherIDBLUE SHIELD
HW140OtherIDBLUE CROSS

National Provider Directory

National Provider Directory
Tax ID family
Reg VI Mental Health Ctr114 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": "1297900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297900800000",
    "number": "1639476294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 TROY HIGHWAY",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838433995",
            "telephone_number": "208-882-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 TROY HIGHWAY",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838433995",
            "telephone_number": "208-882-0562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO DEPT OF HEALTH & WELFARE REG 2 CMH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-17",
        "last_updated": "2011-02-17",
        "status": "A",
        "authorized_official_last_name": "MALONE",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "208-799-4440"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010018450",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "HW140",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moscow, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.