COUNSELING & TREATMENT CENTER OF IDAHO LLC NPI 1093354318

NPI Information

NPI: 1093354318
Provider Name: COUNSELING & TREATMENT CENTER OF IDAHO, LLC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
859 S YELLOWSTONE HWY STE 302
REXBURG, ID
ZIP 83440
Phone: (208) 932-5363
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COUNSELING & TREATMENT CENTER OF IDAHO, LLC is a mental health (including community mental health center) clinic center in Rexburg, ID. COUNSELING & TREATMENT CENTER OF IDAHO, LLC NPI is 1093354318. The provider is registered as an organization entity type.

The provider's business location address is:

859 S YELLOWSTONE HWY STE 302
REXBURG, ID
ZIP 83440-294
Phone: (208) 932-5363
Fax: (205) 273-8403

The provider's authorized official is Deborah Finch .
The authorized official title is Office Manager and has the following contact phone number (801) 857-9136.

The enumeration date for this NPI number is 1/3/2020 and was last updated on 10/23/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0855X	Clinic/Center	Adolescent and Children Mental Health			No
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	IDTPID012974	MEDICAID	IDAHO

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: 11/14/2023

NPI Synchronization or Removal

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