| Idacare Foundation | |
|
2206 N Cole Rd Boise ID 83704-7313 | |
| (208) 451-0101 | |
| Not Available |
| Full Name | Idacare Foundation |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2206 N Cole Rd, Boise, Idaho |
| Authorized Official Name and Position | Shawn J Briley (DIRECTOR) |
| Authorized Official Contact | 2084510101 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idacare Foundation Po Box 1127 Mccall ID 83638-1127 Ph: (208) 451-0101 | Idacare Foundation 2206 N Cole Rd Boise ID 83704-7313 Ph: (208) 451-0101 |
| NPI Number | 1366934283 |
|---|---|
| Provider Enumeration Date | 06/06/2018 |
| Last Update Date | 06/06/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366934283 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW-28826 (Idaho) | Primary |
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