Idaho Dept Of Health & Welfare Reg 7 Cmh P C

LBN: Idaho Dept Of Health & Welfare Reg 7 Cmh P C
Idaho Dept Of Health & Welfare Reg 7 Cmh P C is an health care organization with primary practice located at 720 E Alice , Blackfoot ID 83221-0129. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rehabilitation, which is considered as the primary health care specialty. Idaho Dept Of Health & Welfare Reg 7 Cmh P C can be contacted via phone (208) 785-5871, or through Rodriquez, Randy via phone (208) 528-5700.

Contact Information

Primary practice address
720 E Alice Blackfoot ID 83221-0129
Fax: (208) 785-5877
Website:
Authorized official contact:
Name: Rodriquez, Randy Licensed Clinical Social Worker (LCSW)

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rehabilitation 261QR0400X

Profile Details

NPI number 1639201593
LBN Legal business name Idaho Dept Of Health & Welfare Reg 7 Cmh P C
DBA Doing business as
Authorized official Rodriquez, Randy Licensed Clinical Social Worker (LCSW)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 9th, 2007
Last updated Aug 10th, 2010 - about 14 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 1639201593 NPPES
Idaho Other 000010019677 BLUE SHIELD
Idaho MEDICAID 8073649 BLUE SHIELD
Idaho Other HW157 BLUE SHIELD

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