| Lifepath Supports Inc | |
|
10112 W Overland Rd Boise ID 83709-1428 | |
| (208) 780-3902 | |
| Not Available |
| Full Name | Lifepath Supports Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 10112 W Overland Rd, Boise, Idaho |
| Authorized Official Name and Position | Tiffaney Giles (PAYEE PROVIDER) |
| Authorized Official Contact | 2087803900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifepath Supports Inc 10112 W Overland Rd Boise ID 83709-1428 Ph: (208) 780-3900 | Lifepath Supports Inc 10112 W Overland Rd Boise ID 83709-1428 Ph: (208) 780-3902 |
| NPI Number | 1164899951 |
|---|---|
| Provider Enumeration Date | 08/27/2015 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164899951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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