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IDAHO STATE UNIVERSITY DEPARTMENT OF FAMILY MEDICINE NPI 1780032326


NPI Information

NPI: 1780032326
Provider Name: IDAHO STATE UNIVERSITY DEPARTMENT OF FAMILY MEDICINE
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 13D2099323

Address:
465 MEMORIAL DR
POCATELLO, ID
ZIP 83201
Phone: (208) 282-4141
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IDAHO STATE UNIVERSITY DEPARTMENT OF FAMILY MEDICINE is a community behavioral health in Pocatello, ID. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. IDAHO STATE UNIVERSITY DEPARTMENT OF FAMILY MEDICINE NPI is 1780032326. The provider is registered as an organization entity type.

The provider's business location address is:

465 MEMORIAL DR
POCATELLO, ID
ZIP 83201-008
Phone: (208) 282-4141

The provider's authorized official is Laurie Powell .
The authorized official title is Authorization Specialist and has the following contact phone number (208) 232-6260.

The CLIA number assigned to this NPI record is 13D2099323 - health fair with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/24/2016 and was last updated on 5/24/2016.


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
1251S00000XCommunity/Behavioral HealthYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.