OrganizationActive
Idaho Dept of Health & Welfare Reg 2 Cmh
NPI 1639476294 · Adolescent and Children Mental Health Clinic/Center · Moscow, ID
Provider details
- NPI number
- 1639476294
- Entity type
- Organization
- Primary specialty
- Adolescent and Children Mental Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Vicki Malone, Program Manager(208) 799-4440
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1350 Troy Highway
Moscow, ID 83843-3995
Phone: (208) 882-0562
Street-level locationGet directions
Mailing address
1350 Troy Highway
Moscow, ID 83843-3995
Registry dates
- Enumerated
- 2011-02-17
- Last updated
- 2011-02-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.