Idaho Dept Of Health & Welfare Itp Region 4

LBN: Idaho Dept Of Health & Welfare Itp Region 4
Idaho Dept Of Health & Welfare Itp Region 4 is an health care organization with primary practice located at 1720 Westgate Dr Suite B-2, Boise ID 83704-7164. The organization recently has 2 registered licenses in different health care specialties including Agencies / Local Education Agency (LEA), Agencies / Early Intervention Provider Agency. Agencies / Early Intervention Provider Agency is the primary health care specialty. Idaho Dept Of Health & Welfare Itp Region 4 can be contacted via phone (208) 334-0900, or through Jones, Mary J via phone (208) 334-5523.

Contact Information

Primary practice address
1720 Westgate Dr Suite B-2 Boise ID 83704-7164
Phone: (208) 334-0900
Fax: (208) 334-0926
Website:
Map and Directions
Authorized official contact:
Name: Jones, Mary J B.U.S.
Phone: (208) 334-5523

Health care specialties

SpecialtyCodeLicense #State
Agencies / Local Education Agency (LEA) 251300000X
Agencies / Early Intervention Provider Agency 252Y00000X Idaho

Profile Details

NPI number 1568502409
LBN Legal business name Idaho Dept Of Health & Welfare Itp Region 4
DBA Doing business as
Authorized official Jones, Mary J B.U.S.
Entity Organization
Organization subpart 1 No
Enumeration date Feb 8th, 2007
Last updated Aug 5th, 2013 - about 12 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 1568502409 NPPES
Idaho MEDICAID 0028406
Idaho Other 000010019044
Idaho Other HW306

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