Center for Behavioral Health Idaho, LLC

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

Legal business name

CENTER FOR BEHAVIORAL HEALTH IDAHO, LLC

Practice address

2426 N Merritt Creek Loop Ste B
Coeur D Alene, ID 83814-4961

Phone

(208) 296-5385

Fax

(208) 296-5387

NPI assigned

Mar 30, 2021

Organization subpart

No

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

Authorized official

Name

Jay Higham

Title

Ceo

Phone

(214) 365-6112

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Opioid treatment program

Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Center for Behavioral Health Idaho, LLC

  • Community/Behavioral Health Agency
  • Meridian, ID
  • NPI 1629223128

  O20200218001366

  Same enrollment
• Center for Behavioral Health Idaho, LLC

  • Community/Behavioral Health Agency
  • Boise, ID
  • NPI 1760738645

  O20200218001366

  Same enrollment
• Center for Behavioral Health Idaho, LLC

  • Methadone Clinic
  • Meridian, ID
  • NPI 1811421548

  O20200218001366

  Same enrollment

Tax ID family

Center for Behavioral Health Idaho LLC2 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.

• Center for Behavioral Health Idaho, LLC

  • Community/Behavioral Health Agency
  • Boise, ID
  • NPI 1760738645
  NPD tax ID

Locations

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735171200000",
    "number": "1760060933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 SPRING VALLEY ROAD",
            "address_2": "SUITE 600 EAST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443946",
            "telephone_number": "214-365-6100",
            "fax_number": "214-365-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2426 N MERRITT CREEK LOOP STE B",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144961",
            "telephone_number": "208-296-5385",
            "fax_number": "208-296-5387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR BEHAVIORAL HEALTH IDAHO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-30",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A",
        "authorized_official_last_name": "HIGHAM",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-365-6112"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jamie Cervi-Skinner, PHARMD
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• Amit Kumar Chakraborty, MD

• Methadone Clinic in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Methadone Clinic in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.