P Praxis·MD
● Active Type 2 · Organization

Idaho Dept Of Health & Welfare Reg 6 Cmh Bf C

Clinic/Center·Blackfoot, ID· NPI 1710019476 · Enumerated 2007 · 19 years on NPI
Idaho Dept Of Health & Welfare Reg 6 Cmh Bf C is 1 of 37 clinic/center organizations in Idaho.
NPI age
19 years
Enumerated 2007-03-09
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Axford
Program Manager
Last NPPES update
2020-08-22
Source: monthly bulk 2026-05

How this organization compares

Across 37 active clinic/center providers in Idaho.

NPI age
19 years
↑ 6 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0

NPI lifetime · 2007 → 2026

2007-03Enumerated in NPPES
2007 2026

Where they practice

Primary practice location
701 E Alice
Blackfoot, ID 832210129
📞 2087855826fax 2087851003
Mailing address
Po Box 129
Blackfoot, ID 832210129
📞 2087855826fax 2087851003

Authorized official

Ed Axford
Program Manager
📞 2082347900

Specialties

  • Clinic/Center Primary
    An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family...
    taxonomy 261QM0855X

Identifiers

TypeValueNotes
01 (ID) 000010019402 BLUE SHIELD
01 (ID) HW157 BLUE CROSS
05 (ID) 8073650

Practice context

Single-site organization. Only one practice location on file.

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How to verify this organization

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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