Organization · Type 2 NPI

Andrea Russell

Community/Behavioral Health Agency · Rigby, ID

NPI number 1104769520 Active

Practice location

1200 Jaylee Dr Unit 1
Rigby, ID 83442-5273

Call (208) 419-9383 Map

Specialties and licenses

TaxonomyCodeLicense
Developmental Therapist 222Q00000XNone listed
Community/Behavioral Health Agency Primary 251S00000XNone listed

Community/Behavioral Health Agency: A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day suppo…

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About NPI 1104769520

Andrea Russell's National Provider Identifier is 1104769520, issued on Apr 10, 2026. The primary taxonomy on file is Community/Behavioral Health Agency (251S00000X), and the practice location is in Rigby, ID. The record was last updated on May 13, 2026.