| S.t.a.r.r. Family Behavioral Health, Llc | |
|
10270 La Honton Dr Boise ID 83709-0439 | |
| (208) 250-4561 | |
| (208) 658-1707 |
| Full Name | S.t.a.r.r. Family Behavioral Health, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 10270 La Honton Dr, Boise, Idaho |
| Authorized Official Name and Position | Doug Loertscher (OWNER) |
| Authorized Official Contact | 2082504561 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| S.t.a.r.r. Family Behavioral Health, Llc 10270 La Honton Dr Boise ID 83709-0439 Ph: (208) 250-4561 | S.t.a.r.r. Family Behavioral Health, Llc 10270 La Honton Dr Boise ID 83709-0439 Ph: (208) 250-4561 |
| NPI Number | 1033378146 |
|---|---|
| Provider Enumeration Date | 06/03/2008 |
| Last Update Date | 06/03/2008 |
| Medicare PECOS PAC ID | 8123390317 |
|---|---|
| Medicare Enrollment ID | O20170823001552 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033378146 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Donna D Hislop |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972520617 PECOS PAC ID: 2163579152 Enrollment ID: I20090408000463 |
| Provider Name | Jacqueline Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437429222 PECOS PAC ID: 5597074872 Enrollment ID: I20151028000479 |
| Provider Name | June E Boucher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841716511 PECOS PAC ID: 1759643208 Enrollment ID: I20180320003109 |
| Provider Name | Roma D Hawkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942500996 PECOS PAC ID: 0446596910 Enrollment ID: I20190104001701 |
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