NPIMap

Organization Active NPI

Idaho Dept of Health & Welfare R5 Amh CL

  • Adult Mental Health Clinic/Center
  • Twin Falls, ID
National Provider Identifier
1720119225
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
IDAHO DEPT OF HEALTH & WELFARE R5 AMH CL
Practice address
823 Harrison St
Twin Falls, ID 83301-3925
Phone
(208) 736-2177
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Duke Morton
Title
Field Services Program Manager
Phone
(208) 736-2177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X ID Primary

Addresses

Primary practice location

823 Harrison St
Twin Falls, ID 83301-3925

Mailing address

823 Harrison St
Twin Falls, ID 83301-3925

Other identifiers 3

IdentifierTypeStateIssuer
000010025421OtherIDBLUESHIELD
HW173OtherIDBLUE CROSS
0028319MedicaidID

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

Locations

823 Harrison St
Twin Falls, ID 83301
Phone 2087362177 ext. 1594

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720119225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 HARRISON ST",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 HARRISON ST",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013925",
            "telephone_number": "208-736-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO DEPT OF HEALTH & WELFARE R5 AMH CL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORTON",
        "authorized_official_first_name": "DUKE",
        "authorized_official_title_or_position": "FIELD SERVICES PROGRAM MANAGER",
        "authorized_official_telephone_number": "208-736-2177"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD",
            "identifier": "000010025421",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "HW173",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0028319",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.