| Nvelup Idaho Corp | |
|
3597 E Monarch Sky Ln Ste 240-8464 Meridian ID 83646-1053 | |
| (415) 324-9906 | |
| Not Available |
| Full Name | Nvelup Idaho Corp |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3597 E Monarch Sky Ln Ste 240-8464, Meridian, Idaho |
| Authorized Official Name and Position | Troy Di Lello (PRESIDENT) |
| Authorized Official Contact | 4125324990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nvelup Idaho Corp Po Box 7221 Petaluma CA 94955-7221 Ph: (415) 324-9906 | Nvelup Idaho Corp 3597 E Monarch Sky Ln Ste 240-8464 Meridian ID 83646-1053 Ph: (415) 324-9906 |
| NPI Number | 1184329070 |
|---|---|
| Provider Enumeration Date | 03/31/2023 |
| Last Update Date | 03/31/2023 |
| Certification Date | 03/31/2023 |
| Medicare PECOS PAC ID | 4789046400 |
|---|---|
| Medicare Enrollment ID | O20230814000120 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184329070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Karen Schaaf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295704484 PECOS PAC ID: 8628099561 Enrollment ID: I20230802002383 |
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