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Contact Information

IDAHO DEPT OF HEALTH & WELFARE ITP REGION 6
421 MEMORIAL DR
POCATELLO, ID83201-4008
 Phone: 208-234-7900
 Fax: 208-236-6328
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Early Intervention Provider Agency

252Y00000X
 

Local Education Agency (LEA)

251300000X
Indicates primary specialty

NPI Profile & details for IDAHO DEPT OF HEALTH & WELFARE ITP REGION 6

NPI # 1164563508
LBN Legal business name IDAHO DEPT OF HEALTH & WELFARE ITP REGION 6
Authorized official MARY JONES - (PROGRAM MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/09/2007
Last updated 08/05/2013 - About 13 years ago
Identifiers
ID Medicaid 0028414
ID Other HW165 BLUE CROSS OF IDAHO
ID Other 000010019386 BLUE SHIELD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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