NPI 1003145533 · live from the CMS NPI Registry
Ambitions Of Idaho, INC
Clinic/Center, Mental Health (Including Community Mental Health Center) in Coeur D Alene, ID. National Provider Identifier 1003145533, active.
NPI record
| NPI | 1003145533 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center, Mental Health (Including Community Mental Health Center) 261QM0801X |
| Practice location | 1044 Northwest Blvd Ste C, Coeur D Alene, ID 83814 |
| Practice phone | 208-930-1740 |
| Enumerated | December 11, 2009 |
| Last updated | October 12, 2023 |
| Authorized official | Shane Hagel, President |
| Other names | Ambitions |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Community/Behavioral Health | 251S00000X | — |
| Clinic/Center, Adult Mental Health | 261QM0850X | — |
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | 320900000X | — |
| Counselor, Professional | 101YP2500X | — |
| Social Worker, Clinical | 1041C0700X | — |
| Psychiatry & Neurology, Child & Adolescent Psychiatry | 2084P0804X | — |
| Case Management | 251B00000X | — |
| Clinic/Center, Mental Health (Including Community Mental Health Center) primary | 261QM0801X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.