| Gericare Of Idaho, Llc | |
|
5442 S Farmhouse Pl Boise ID 83716-9016 | |
| (208) 830-6775 | |
| Not Available |
| Full Name | Gericare Of Idaho, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5442 S Farmhouse Pl, Boise, Idaho |
| Authorized Official Name and Position | Bernard M Berlin (OWNER) |
| Authorized Official Contact | 2088306775 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gericare Of Idaho, Llc 5310 Ward Road Suite 106 Arvada CO 80002-1829 Ph: (303) 278-7418 | Gericare Of Idaho, Llc 5442 S Farmhouse Pl Boise ID 83716-9016 Ph: (208) 830-6775 |
| NPI Number | 1144546649 |
|---|---|
| Provider Enumeration Date | 04/09/2010 |
| Last Update Date | 04/09/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144546649 | NPI | - | NPPES |
| LCS 10041 | Other | CA | STATE LICENSE |
| LCSW-29777 | Other | ID | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW-29777 (Idaho) | Primary |
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