MOUNTAIN HOME RTC – NPI #1073843868
Residential Treatment Facility, Emotionally Disturbed Children

A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

MOUNTAIN HOME RTC is a residential treatment facility located in MOUNTAIN HOME, ID. NPPES has assigned the NPI number 1073843868 to MOUNTAIN HOME RTC on December 30, 2009. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “MOUNTAIN HOME RTC” is a dba name, the actual legal business name for this organization is SEQUEL TSI OF IDAHO, LLC. The primary taxonomy selected by this provider is 322D00000X from the Health Care Provider Taxonomy code set, which is classified as Residential Treatment Facility, Emotionally Disturbed Children.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MOUNTAIN HOME RTC below.

NPI Profile for
SEQUEL TSI OF IDAHO, LLC

NPI Number
1073843868
Enumeration Date

(more than 16 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SEQUEL TSI OF IDAHO, LLC
Doing Business As (dba): MOUNTAIN HOME RTC
Primary location
2850 INDUSTRIAL WAY
MOUNTAIN HOME, ID 83647-3960
Phone: (208) 587-2679 Fax: (208) 587-2875
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JOHN STUPAK
PRESIDENT
Phone: (267) 419-8913
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
322D00000X
- Residential Treatment Facility, Emotionally Disturbed Children (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.