| Cpf Idaho Behavioral Health, Llc | |
|
2273 S. Vista Ave 190 Boise ID 83705 | |
| (208) 343-2737 | |
| (208) 343-3238 |
| Full Name | Cpf Idaho Behavioral Health, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2273 S. Vista Ave, Boise, Idaho |
| Authorized Official Name and Position | Cheryl Green (BILLING SUPERVISOR) |
| Authorized Official Contact | 2083432737 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cpf Idaho Behavioral Health, Llc 2273 S Vista Ave Ste 190 Boise ID 83705-7341 Ph: (208) 343-2737 | Cpf Idaho Behavioral Health, Llc 2273 S. Vista Ave 190 Boise ID 83705 Ph: (208) 343-2737 |
| NPI Number | 1871259770 |
|---|---|
| Provider Enumeration Date | 11/15/2021 |
| Last Update Date | 05/15/2025 |
| Certification Date | 05/15/2025 |
| Medicare PECOS PAC ID | 8729472238 |
|---|---|
| Medicare Enrollment ID | O20220228000470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871259770 | NPI | - | NPPES |
| Provider Name | Deborah L Woodall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215166038 PECOS PAC ID: 4284954579 Enrollment ID: I20150528001299 |
| Provider Name | Nancy J L 'heureux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003282708 PECOS PAC ID: 4587972880 Enrollment ID: I20151007000530 |
| Provider Name | Aida Dizdar-barac |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952655490 PECOS PAC ID: 2365743325 Enrollment ID: I20151216000308 |
| Provider Name | Madison M Caldwell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275147712 PECOS PAC ID: 9436509585 Enrollment ID: I20240102001828 |
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