NPIMap

Organization Active NPI

Abundance Behavioral Health Services Inc.

  • Developmentally Disabled Services Day Training Agency
  • Caldwell, ID
National Provider Identifier
1669775060
Registry record updated Dec 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
ABUNDANCE BEHAVIORAL HEALTH SERVICES INC.
Practice address
201 N 21St Ave
Caldwell, ID 83605-4371
Phone
(208) 455-1222
Fax
(208) 455-2559
NPI assigned
Dec 8, 2010
Last updated
Dec 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2010

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

Authorized official

Name
Ms. Molly Virginia Legge, C.C.R.C.
Title
Director
Phone
(208) 455-1222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

201 N 21St Ave
Caldwell, ID 83605-4371

Mailing address

201 N 21St Ave
Caldwell, ID 83605-4371
Phone (208) 455-1222

Other identifiers 3

IdentifierTypeStateIssuer
1669795308MedicaidID
1891913125MedicaidID
1659590727MedicaidID

National Provider Directory

National Provider Directory
Tax ID family
Abundance Behavioral Health Service Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

201 N 21st Ave
Caldwell, ID 83605
Phone (208) 455-1222

Practitioners & affiliated clinicians

Practitioners 3

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": "1291766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291766400000",
    "number": "1669775060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N 21ST AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054371",
            "telephone_number": "208-455-1222",
            "fax_number": "208-455-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N 21ST AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054371",
            "telephone_number": "208-455-1222",
            "fax_number": "208-455-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANCE BEHAVIORAL HEALTH SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-08",
        "last_updated": "2010-12-08",
        "status": "A",
        "authorized_official_last_name": "LEGGE",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_middle_name": "VIRGINIA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "208-455-1222",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "C.C.R.C."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669795308",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891913125",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659590727",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.