Provider Demographics
NPI:1568763076
Name:JOINT POWERS ENTITY
Entity Type:Organization
Organization Name:JOINT POWERS ENTITY
Other - Org Name:ALLUMBAUGH HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN, MAYOR CITY OF BOISE
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BEITER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-384-4422
Mailing Address - Street 1:400 N ALLUMBAUGH ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-9209
Mailing Address - Country:US
Mailing Address - Phone:208-377-9669
Mailing Address - Fax:208-377-1028
Practice Address - Street 1:400 N ALLUMBAUGH ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-9209
Practice Address - Country:US
Practice Address - Phone:208-377-9669
Practice Address - Fax:208-377-1028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID323P00000X, 324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility