| One Love Agency | |
|
3649 N Lakeharbor Ln Boise ID 83703-6913 | |
| (435) 553-9822 | |
| (208) 853-5377 |
| Full Name | One Love Agency |
|---|---|
| Speciality | Clinic/Center |
| Location | 3649 N Lakeharbor Ln, Boise, Idaho |
| Authorized Official Name and Position | Rick Adolpho (OWNER) |
| Authorized Official Contact | 4355539822 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| One Love Agency 3649 N Lakeharbor Ln Boise ID 83703-6913 Ph: (435) 553-9822 | One Love Agency 3649 N Lakeharbor Ln Boise ID 83703-6913 Ph: (435) 553-9822 |
| NPI Number | 1932454642 |
|---|---|
| Provider Enumeration Date | 07/18/2012 |
| Last Update Date | 05/23/2024 |
| Certification Date | 05/23/2024 |
| Medicare PECOS PAC ID | 1254552581 |
|---|---|
| Medicare Enrollment ID | O20141029001984 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932454642 | NPI | - | NPPES |
| 1932454642 | Medicaid | ID |
| Provider Name | Matthew R Christensen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013275544 PECOS PAC ID: 0042629255 Enrollment ID: I20210429000289 |
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