Idaho Department Of Health & Welfare Region 7 Amh Clinic If

LBN: Idaho Department Of Health & Welfare Region 7 Amh Clinic If
Idaho Department Of Health & Welfare Region 7 Amh Clinic If is an health care organization with primary practice located at 150 Shoup Ave Suite 17, Idaho Falls ID 83402-3657. The organization recently has only one registered license in Ambulatory Health Care Facilities / Adult Mental Health, which is considered as the primary health care specialty. Idaho Department Of Health & Welfare Region 7 Amh Clinic If can be contacted via phone (208) 528-5700, or through Bean, Melissa M via phone (208) 528-5706.

Contact Information

Primary practice address
150 Shoup Ave Suite 17 Idaho Falls ID 83402-3657
Fax: (208) 528-5747
Website:
Authorized official contact:
Name: Bean, Melissa M Master of Arts (MA)

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X

Profile Details

NPI number 1558497966
LBN Legal business name Idaho Department Of Health & Welfare Region 7 Amh Clinic If
DBA Doing business as
Authorized official Bean, Melissa M Master of Arts (MA)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 27th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558497966 NPPES
Idaho MEDICAID 8061288
Idaho Other HW181
Idaho Other 000010019677

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