Organization Active NPI

Treasure Valley Behavioral Health, LLC

  • Community/Behavioral Health Agency
  • Fruitland, ID
National Provider Identifier
1790806065
Registry record updated Nov 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
TREASURE VALLEY BEHAVIORAL HEALTH, LLC
Practice address
131 N Whitley Dr
Fruitland, ID 83619-2172
Phone
(208) 452-7705
Fax
(208) 452-7750
NPI assigned
Apr 3, 2007
Last updated
Nov 5, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2012

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

Authorized official

Name
Bradi Fritts, LMSWNPI 1043517105
Title
Owner /Therapist
Phone
(208) 452-7705

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 NU Primary

Addresses

Primary practice location

131 N Whitley Dr
Fruitland, ID 83619-2172

Mailing address

131 N Whitley Dr.
Fruitland, ID 83619
Phone (208) 452-7705

Other identifiers 1

IdentifierTypeStateIssuer
807398400MedicaidID

National Provider Directory

National Provider Directory
Tax ID family
Treasure Valley Behavioral Health 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.

Locations

131 N Whitley Dr
Fruitland, ID 83619
Phone (208) 452-6453

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352073600000",
    "number": "1790806065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 N WHITLEY DR.",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "83619",
            "telephone_number": "208-452-7705",
            "fax_number": "208-452-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 N WHITLEY DR",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192172",
            "telephone_number": "208-452-7705",
            "fax_number": "208-452-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREASURE VALLEY BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2012-11-05",
        "status": "A",
        "authorized_official_last_name": "FRITTS",
        "authorized_official_first_name": "BRADI",
        "authorized_official_title_or_position": "OWNER /THERAPIST",
        "authorized_official_telephone_number": "208-452-7705",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807398400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fruitland, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; 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.