NPIMap

Organization Active NPI

Easterseals-Goodwill Northern Rocky Mountain, Inc.

  • Community/Behavioral Health Agency
  • Boise, ID
National Provider Identifier
1740305135
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EASTERSEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC.
Practice address
1408 W Hays St
Boise, ID 83702-5028
Phone
(208) 345-2208
NPI assigned
Mar 21, 2007
Last updated
Mar 26, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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

Authorized official

Name
Mark Sherman
Title
Cfo
Phone
(406) 771-3762

Specialties & licenses 1

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

Addresses

Primary practice location

1408 W Hays St
Boise, ID 83702-5028

Mailing address

425 1St Ave N
Great Falls, MT 59401-2507
Phone (406) 761-3680

Other identifiers 1

IdentifierTypeStateIssuer
80761200MedicaidID

National Provider Directory

National Provider Directory
Tax ID family
Easter Seal Society25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553558400000",
    "number": "1740305135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 1ST AVE N",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594012507",
            "telephone_number": "406-761-3680",
            "fax_number": "406-761-1390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 W HAYS ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025028",
            "telephone_number": "208-345-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERSEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2019-03-26",
        "status": "A",
        "authorized_official_last_name": "SHERMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "406-771-3762"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80761200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; 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.