Healthcare Provider Details

I. General information

NPI: 1720691249
Provider Name (Legal Business Name): UZIMA HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2020
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 S ORCHARD ST STE 245
BOISE ID
83705-1964
US

IV. Provider business mailing address

1111 S ORCHARD ST STE 245
BOISE ID
83705-1964
US

V. Phone/Fax

Practice location:
  • Phone: 208-867-9403
  • Fax: 888-786-4470
Mailing address:
  • Phone: 208-867-9403
  • Fax: 888-786-4470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: HEIDI ALYSSA STARK
Title or Position: SENIOR PARTNER
Credential:
Phone: 208-867-9403