Boise House Calls, Llc | |
303 Elk Creek Road Suite Box 88 Idaho City ID 83631 | |
(208) 848-6703 | |
(208) 392-4128 |
Full Name | Boise House Calls, Llc |
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Speciality | Clinic/center - Primary Care |
Location | 303 Elk Creek Road, Idaho City, Idaho |
Authorized Official Name and Position | Lynda Joanne Maricle-kuwahara (OWNER) |
Authorized Official Contact | 2084846703 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Boise House Calls, Llc 303 Elk Creek Road Po Box 88 Idaho City ID 83631 Ph: (208) 484-6703 | Boise House Calls, Llc 303 Elk Creek Road Suite Box 88 Idaho City ID 83631 Ph: (208) 848-6703 |
NPI Number | 1154877918 |
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Provider Enumeration Date | 08/31/2016 |
Last Update Date | 08/31/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154877918 | NPI | - | NPPES |
804161900 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | NP 289 (Idaho) | Primary |