TRIVIUM LIFE SERVICES MOUNTAIN WEST LLC NPI 1194962829

NPI Information

  • NPI: 1194962829
  • Provider Name: TRIVIUM LIFE SERVICES MOUNTAIN WEST, LLC
  • Classification: Clinic/Center - 261QR0405X
  • Specialization: Rehabilitation, Substance Use Disorder
  • Entity Type: Organization
  • :
  • CLIA Number: 13D1095117
  • Address: 12553 W EXPLORER DR STE 190
    BOISE, ID
    ZIP 83713
  • Phone: (208) 376-7083

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NPI Details

TRIVIUM LIFE SERVICES MOUNTAIN WEST, LLC is a rehabilitation and substance use disorder clinic center in Boise, ID. TRIVIUM LIFE SERVICES MOUNTAIN WEST, LLC NPI is 1194962829. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

12553 W EXPLORER DR STE 190
BOISE, ID
ZIP 83713-612
Phone: (208) 376-7083
Fax: (208) 321-5069

The provider's authorized official is Michelle Francesca Schaller .
The authorized official title is Senior Director Of Bh & Rcm and has the following contact phone number (712) 355-8480.

The CLIA number assigned to this NPI record is 13D1095117 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/16/2009 and was last updated on 11/19/2025.

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
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
2251S00000XCommunity/Behavioral HealthNo
3101YA0400XCounselorAddiction (Substance Use Disorder)No
4261QR0405XClinic/CenterRehabilitation, Substance Use DisorderIDAHOYes

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: 11/21/2025

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