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Organization
CASE MANAGERS OF IDAHO, LLC
Active
Organization
CASE MANAGERS OF IDAHO, LLC
Active
Other names
Veteran Community Support Specialists of Idaho, Community Based Services of Idaho, Mental Health Counselors of Idaho, Peer Support Specialists of Idaho
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK KIRK (EXECUTIVE DIRECTOR)
(208) 801-6806
Entity
Organization
Contact information
Practice address
6003 W OVERLAND RD STE 201, BOISE, ID 83709-3076
(208) 801-6806
(208) 694-6301
Mailing address
6003 W OVERLAND RD STE 201, BOISE, ID 83709-3076
(208) 801-6806
(208) 694-6301
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366007775
—
ID
Enumeration date
05/01/2019
Last updated
05/16/2024
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