NPIMap

Organization Active NPI

Idaho Dept of Health & Welfare

  • Adolescent and Children Mental Health Clinic/Center
  • Payette, ID
National Provider Identifier
1689984254
Registry record updated Oct 18, 2010
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
Practice address
515 16TH Ave N
Payette, ID 83661-2047
Phone
(208) 642-6412
Fax
(208) 642-2829
NPI assigned
Oct 18, 2010
Last updated
Oct 18, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2010

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

Authorized official

Name
Todd Hurt
Title
Program Manager
Phone
(208) 455-7057

Specialties & licenses 1

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

Addresses

Primary practice location

515 16TH Ave N
Payette, ID 83661-2047

Mailing address

515 16TH Ave N
Payette, ID 83661-2047
Phone (208) 642-6412

Other identifiers 2

IdentifierTypeStateIssuer
000010018824OtherIDBLUESHIELD
HW348OtherIDBLUE CROSS OF IDAHO

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": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287360000000",
    "number": "1689984254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 16TH AVE N",
            "city": "PAYETTE",
            "state": "ID",
            "postal_code": "836612047",
            "telephone_number": "208-642-6412",
            "fax_number": "208-642-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 16TH AVE N",
            "city": "PAYETTE",
            "state": "ID",
            "postal_code": "836612047",
            "telephone_number": "208-642-6412",
            "fax_number": "208-642-2829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO DEPT OF HEALTH & WELFARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2010-10-18",
        "status": "A",
        "authorized_official_last_name": "HURT",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "208-455-7057"
    },
    "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": "BLUESHIELD",
            "identifier": "000010018824",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "HW348",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Payette, ID

Sources for this page

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