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CASE MANAGERS OF IDAHO LLC NPI 1366007775


NPI Information

NPI: 1366007775
Provider Name: CASE MANAGERS OF IDAHO, LLC

Doing Business As: VETERAN COMMUNITY SUPPORT SPECIALISTS OF IDAHO

Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
6003 W OVERLAND RD STE 201
BOISE, ID
ZIP 83709
Phone: (208) 801-6806
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CASE MANAGERS OF IDAHO, LLC is a mental health counselor in Boise, ID. CASE MANAGERS OF IDAHO, LLC NPI is 1366007775. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Veteran Community Support Specialists Of Idaho.

The provider's business location address is:

6003 W OVERLAND RD STE 201
BOISE, ID
ZIP 83709-076
Phone: (208) 801-6806
Fax: (208) 694-6301

The provider's authorized official is Patrick Kirk .
The authorized official title is Executive Director and has the following contact phone number (208) 801-6806.

The enumeration date for this NPI number is 5/1/2019 and was last updated on 3/31/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1171M00000XCase Manager/Care CoordinatorNo
2175T00000XPeer SpecialistNo
3251S00000XCommunity/Behavioral HealthNo
4343900000XNon-emergency Medical Transport (VAN)No
5363AM0700XPhysician AssistantMedicalNo
6101YM0800XCounselorMental HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11366007775MEDICAIDIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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