Human Supports of Idaho, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

HUMAN SUPPORTS OF IDAHO, INC

Practice address

314 Badiola St
Caldwell, ID 83605-4389

Phone

(208) 454-8389

Fax

(208) 454-8404

NPI assigned

Feb 14, 2007

Organization subpart

No

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

Authorized official

Name

Gregory Leroy Dickerson, LMSW

Title

Administrator

Phone

(208) 321-0160

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

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

• Human Supports of Idaho

  • General Practice Physician
  • Caldwell, ID
  • NPI 1700129491

  O20130305000118

  Same enrollment
• Human Supports of Idaho

  • Psychiatry Physician
  • Boise, ID
  • NPI 1922340124

  O20130305000118

  Same enrollment
• Human Supports of Idaho, Inc.

  • Community/Behavioral Health Agency
  • Boise, ID
  • NPI 1558404129

  O20130305000118

  Same enrollment

Tax ID family

Human Supports of Idaho Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• Human Supports of Idaho, Inc

  • Community/Behavioral Health Agency
  • Caldwell, ID
  • NPI 1598145252
  NPD tax ID
• Human Supports of Idaho, Inc.

  • Community/Behavioral Health Agency
  • Caldwell, ID
  • NPI 1376686915
  NPD tax ID
• Human Supports of Idaho, Inc.

  • Case Management Agency
  • Caldwell, ID
  • NPI 1376686949
  NPD tax ID
• Human Supports of Idaho, Inc.

  • Community/Behavioral Health Agency
  • Boise, ID
  • NPI 1902949548
  NPD tax ID

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380499200000",
    "number": "1972646511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836060820",
            "telephone_number": "208-454-8389",
            "fax_number": "208-454-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 BADIOLA ST",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054389",
            "telephone_number": "208-454-8389",
            "fax_number": "208-454-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMAN SUPPORTS OF IDAHO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2013-09-30",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "LEROY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "208-321-0160",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807338200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judy Ann Hudson, LCSW
• Kara Jo Hudson, LCPC
• Melinda Sue Hughes, P.A.-C
• Human Supports of Idaho
• Human Supports of Idaho, Inc
• Human Supports of Idaho, Inc.
• Human Supports of Idaho, Inc.
• Jee Hur, MD
• Ashley R Hust, BA
• Sausha Nichole Hyatt, LCSW

• Community/Behavioral Health Agency in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Community/Behavioral Health Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; 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.