| Idaho Memory & Aging Center Pllc | |
|
413 N Allumbaugh St Ste# 101 Boise ID 83704-9212 | |
| (617) 922-4957 | |
| Not Available |
| Full Name | Idaho Memory & Aging Center Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Geriatric Psychiatry |
| Location | 413 N Allumbaugh St, Boise, Idaho |
| Authorized Official Name and Position | Abhilash K Desai (MEDICAL DIRECTOR) |
| Authorized Official Contact | 6179224957 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Memory & Aging Center Pllc 413 N Allumbaugh St Ste# 101 Boise ID 83704-9212 Ph: (617) 922-4957 | Idaho Memory & Aging Center Pllc 413 N Allumbaugh St Ste# 101 Boise ID 83704-9212 Ph: (617) 922-4957 |
| NPI Number | 1730528548 |
|---|---|
| Provider Enumeration Date | 06/14/2013 |
| Last Update Date | 07/19/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730528548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | M-12079 (Idaho) | Primary |
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