| Idacare Inc. | |
|
2206 N Cole Rd Boise ID 83704-7313 | |
| (208) 451-0101 | |
| Not Available |
| Full Name | Idacare Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 2206 N Cole Rd, Boise, Idaho |
| Authorized Official Name and Position | Shawn Joyce Briley (DIRECTOR) |
| Authorized Official Contact | 2084510101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Idacare Inc. Po Box 1127 Mccall ID 83638-1127 Ph: (208) 451-0101 | Idacare Inc. 2206 N Cole Rd Boise ID 83704-7313 Ph: (208) 451-0101 |
| NPI Number | 1245781053 |
|---|---|
| Provider Enumeration Date | 10/17/2016 |
| Last Update Date | 05/18/2019 |
| Medicare PECOS PAC ID | 0749521722 |
|---|---|
| Medicare Enrollment ID | O20191018001832 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245781053 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Shawn J Briley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801068127 PECOS PAC ID: 7618027863 Enrollment ID: I20090609000314 |
| Provider Name | Tami L Bishop |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255836748 PECOS PAC ID: 8729342100 Enrollment ID: I20180511000509 |
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