Healthcare Provider Details

I. General information

NPI: 1427419647
Provider Name (Legal Business Name): A L P H A CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2016
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

537 W BANNOCK ST STE 100
BOISE ID
83702-5759
US

IV. Provider business mailing address

537 W BANNOCK ST STE 100
BOISE ID
83702-5759
US

V. Phone/Fax

Practice location:
  • Phone: 208-424-7799
  • Fax: 208-629-1260
Mailing address:
  • Phone: 208-424-7799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER BIDIMAN
Title or Position: DIRECTOR/OWNER
Credential: RN, BSN
Phone: 208-596-2701