Idaho Youth Ranch

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

IDAHO YOUTH RANCH

Practice address

5465 W Irving St
Boise, ID 83706-1213

Phone

(208) 377-2613

NPI assigned

Oct 1, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Kimberly Thomas, CPA

Title

Cfo

Phone

(208) 377-2613

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680739200000",
    "number": "1952738262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5465 W IRVING ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5465 W IRVING ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061213",
            "telephone_number": "208-377-2613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO YOUTH RANCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-01",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "208-377-2613",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Idaho Virtual Academy
• Idahome Caregivers
• Amy A Iddings, LCSW
• Ideal Health
• Idx Pathology Inc
• Idx Pathology PA

• Adolescent and Children Mental Health Clinic/Center in Boise, ID
• Providers in Boise, ID by specialty
• Adolescent and Children Mental Health Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; 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.