NPIMap

Organization Active NPI

Idaho Dept of Health & Welfare Amh Clinic MH

  • Adult Mental Health Clinic/Center
  • Mountain Home, ID
National Provider Identifier
1760512644
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 AMH CLINIC MH
Practice address
2420 American Legion Blvd
Mountain Home, ID 83647-3146
Phone
(208) 587-9061
Fax
(208) 587-5024
NPI assigned
Mar 7, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Gina Westcott, M.A.
Title
Program Manager
Phone
(208) 334-0969

Specialties & licenses 1

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

Addresses

Primary practice location

2420 American Legion Blvd
Mountain Home, ID 83647-3146

Mailing address

1720 Westgate Dr
Suite B-1
Boise, ID 83704-7164
Phone (208) 334-0894

Other identifiers 3

IdentifierTypeStateIssuer
000010018973OtherBLUE SHIELD
8075987MedicaidID
HW280OtherBLUE CROSS OF IDAHO

National Provider Directory

National Provider Directory
Tax ID family
Idaho Dept of Health Welfare Reg II Amh Grangeville114 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

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760512644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 WESTGATE DR",
            "address_2": "SUITE B-1",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837047164",
            "telephone_number": "208-334-0894",
            "fax_number": "208-334-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 AMERICAN LEGION BLVD",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836473146",
            "telephone_number": "208-587-9061",
            "fax_number": "208-587-5024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO DEPT OF HEALTH & WELFARE AMH CLINIC MH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WESTCOTT",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "208-334-0969",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010018973",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8075987",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "HW280",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, 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.