NPIMap

Organization Active NPI

Diversified Social Services, Inc.

  • Community/Behavioral Health Agency
  • Dalton Gardens, ID
National Provider Identifier
1720141906
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
DIVERSIFIED SOCIAL SERVICES, INC.
Practice address
5624 N Government Way Ste 7B
Dalton Gardens, ID 83815-7350
Phone
(208) 762-9890
Fax
(208) 762-9892
NPI assigned
Dec 18, 2006
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
Mrs. Kristina Nicholas Anderson, LSW, CPRPNPI 1790904779
Title
Administrator
Phone
(208) 762-9890

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

5624 N Government Way Ste 7B
Dalton Gardens, ID 83815-7350

Mailing address

5624 N Government Way Ste 7B
Dalton Gardens, ID 83815-7350
Phone (208) 762-9890

National Provider Directory

National Provider Directory
Tax ID family
Diversified Social Services Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

5624 N Government Way
Ste 7B
Dalton Gardens, ID 83815
Phone (208) 762-9890

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720141906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5624 N GOVERNMENT WAY STE 7B",
            "city": "DALTON GARDENS",
            "state": "ID",
            "postal_code": "838157350",
            "telephone_number": "208-762-9890",
            "fax_number": "208-762-9892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5624 N GOVERNMENT WAY STE 7B",
            "city": "DALTON GARDENS",
            "state": "ID",
            "postal_code": "838157350",
            "telephone_number": "208-762-9890",
            "fax_number": "208-762-9892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSIFIED SOCIAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NICHOLAS ANDERSON",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "208-762-9890",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LSW, CPRP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton Gardens, 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.