Idahodhwbh3 Payette Cmh Psr

LBN: Idahodhwbh3 Payette Cmh Psr
Idahodhwbh3 Payette Cmh Psr is an health care organization with primary practice located at 515 16Th Ave N , Payette ID 83661-2047. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rehabilitation, which is considered as the primary health care specialty. Idahodhwbh3 Payette Cmh Psr can be contacted via phone (208) 642-6416, or through Hurt, Todd L via phone (208) 455-7057.

Contact Information

Primary practice address
515 16Th Ave N Payette ID 83661-2047
Phone: (208) 642-6416
Fax: (208) 642-2829
Website:
Map and Directions
Authorized official contact:
Name: Hurt, Todd L M.S.
Phone: (208) 455-7057

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rehabilitation 261QR0400X

Profile Details

NPI number 1154459444
LBN Legal business name Idahodhwbh3 Payette Cmh Psr
DBA Doing business as
Authorized official Hurt, Todd L M.S.
Entity Organization
Organization subpart 1 No
Enumeration date Mar 1st, 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 1154459444 NPPES
Idaho MEDICAID 8073442
Idaho Other HW348
Idaho Other 000010018824

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