| Renee O. Bild, Pllc | |
|
1718 W Jefferson St Boise ID 83702-3949 | |
| (208) 336-3031 | |
| (208) 336-3228 |
| Full Name | Renee O. Bild, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1718 W Jefferson St, Boise, Idaho |
| Authorized Official Name and Position | Renee Bild (OWNER) |
| Authorized Official Contact | 2083363031 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renee O. Bild, Pllc 1718 W Jefferson St Boise ID 83702-3949 Ph: (208) 336-3031 | Renee O. Bild, Pllc 1718 W Jefferson St Boise ID 83702-3949 Ph: (208) 336-3031 |
| NPI Number | 1174916969 |
|---|---|
| Provider Enumeration Date | 03/18/2015 |
| Last Update Date | 03/18/2015 |
| Medicare PECOS PAC ID | 8628398773 |
|---|---|
| Medicare Enrollment ID | O20150513002077 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174916969 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1338 (Idaho) | Primary |
| Provider Name | Renee Ours Bild |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598725277 PECOS PAC ID: 9537489687 Enrollment ID: I20150513002183 |
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