| Living Hope Clinic Inc | |
|
3308 N Cole Rd Suite A Boise ID 83704-4403 | |
| (208) 378-1122 | |
| Not Available |
| Full Name | Living Hope Clinic Inc |
|---|---|
| Speciality | Counselor |
| Location | 3308 N Cole Rd, Boise, Idaho |
| Authorized Official Name and Position | Charles M Rice (OWNER) |
| Authorized Official Contact | 2083781122 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Hope Clinic Inc 3308 N Cole Rd Suite A Boise ID 83704-4403 Ph: (208) 378-1122 | Living Hope Clinic Inc 3308 N Cole Rd Suite A Boise ID 83704-4403 Ph: (208) 378-1122 |
| NPI Number | 1306901749 |
|---|---|
| Provider Enumeration Date | 12/26/2006 |
| Last Update Date | 08/13/2007 |
| Medicare PECOS PAC ID | 1254432974 |
|---|---|
| Medicare Enrollment ID | O20071127000176 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306901749 | NPI | - | NPPES |
| N9212 | Other | ID | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Charles M Rice |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336176171 PECOS PAC ID: 8527154533 Enrollment ID: I20071022000257 |
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