| Adolpho Enterprise Llc. | |
|
3649 N Lakeharbor Ln Boise ID 83703-6913 | |
| (435) 553-9822 | |
| (208) 853-5377 |
| Full Name | Adolpho Enterprise Llc. |
|---|---|
| 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 |
|---|---|
| Adolpho Enterprise Llc. 3649 N Lakeharbor Ln Boise ID 83703-6913 Ph: (435) 553-9822 | Adolpho Enterprise Llc. 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 | Patrece Moody Meza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649250564 PECOS PAC ID: 7012930241 Enrollment ID: I20060113000074 |
| Provider Name | Jeffrey C Haskell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073535506 PECOS PAC ID: 6709067135 Enrollment ID: I20110218000114 |
| Provider Name | Jane E Krumm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578559308 PECOS PAC ID: 9830342740 Enrollment ID: I20121228000375 |
| Provider Name | Ronald K Sebreros |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386901627 PECOS PAC ID: 2062738792 Enrollment ID: I20150224000703 |
| Provider Name | Aaron Ashby Harris |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669480091 PECOS PAC ID: 3072751593 Enrollment ID: I20181129001929 |
| Provider Name | Janeil Erb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770986531 PECOS PAC ID: 8527437052 Enrollment ID: I20221206000610 |
| Provider Name | Leslie Barton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467586073 PECOS PAC ID: 7012368004 Enrollment ID: I20240918001464 |
| Provider Name | William Kelly Hill |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811256852 PECOS PAC ID: 5597206417 Enrollment ID: I20240919000300 |
| Provider Name | Jennifer Leslie Gallup |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1609648807 PECOS PAC ID: 7214478981 Enrollment ID: I20240920002963 |
| Provider Name | Hollie Deann Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336668391 PECOS PAC ID: 3274977541 Enrollment ID: I20250204001978 |
Sunderlin Behavioral Interventions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3113 W Rose Hill St, Boise, ID 83705 Phone: 208-297-1405 Fax: 805-823-4462 | |
Boise Behavioral Medicine Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7227 W Potomac Dr, Boise, ID 83704 Phone: 208-314-1770 | |
Phyllis Mckinley Viviani, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 N Latah St Ste C, Boise, ID 83706 Phone: 208-918-2810 | |
Saint Alphonsus Regional Medical Center Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 131 Allumbaugh St, Boise, ID 83704 Phone: 208-367-3069 Fax: 208-367-3002 | |
Saint Alphonsus Regional Medical Center Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 901 N Curtis Rd Ste 204, Boise, ID 83706 Phone: 208-367-3315 | |
Living Well, Inc, Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6003 W Overland Rd, Suite 101, Boise, ID 83709 Phone: 208-322-2412 Fax: 208-345-2077 | |
Continual Wellness Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 950 W Bannock St # Ss, Boise, ID 83702 Phone: 208-602-7007 |