| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| 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 |