NPIMap

Organization Active NPI

Clearwater Care Center, Inc.

  • Mental Illness Intermediate Care Facility
  • Twin Falls, ID
National Provider Identifier
1740303239
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Intermediate Care FacilityTaxonomy code 310500000X
Legal business name
CLEARWATER CARE CENTER, INC.
Practice address
1411 Falls Ave E
Suite 703
Twin Falls, ID 83301-3455
Phone
(208) 734-8973
Fax
(208) 734-1075
NPI assigned
Apr 9, 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
Rene Stephens
Title
Administrator
Phone
(208) 734-8973

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Intermediate Care Facility 310500000X ID Primary

Addresses

Primary practice location

1411 Falls Ave E
Suite 703
Twin Falls, ID 83301-3455

Mailing address

1411 Falls Ave E
Suite 703
Twin Falls, ID 83301-3455
Phone (208) 734-8973

Other names 1

  • Bitterroot Home Other name

National Provider Directory

National Provider Directory
Tax ID family
Bitterroot Home5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740303239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 FALLS AVE E",
            "address_2": "SUITE 703",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013455",
            "telephone_number": "208-734-8973",
            "fax_number": "208-734-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 FALLS AVE E",
            "address_2": "SUITE 703",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013455",
            "telephone_number": "208-734-8973",
            "fax_number": "208-734-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWATER CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "RENE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "208-734-8973"
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bitterroot Home",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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.