Healthcare Provider Details

I. General information

NPI: 1437208899
Provider Name (Legal Business Name): AUTOBUS VENTURES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8590 W FAIRVIEW AVE STE A
BOISE ID
83704-8320
US

IV. Provider business mailing address

8590 W FAIRVIEW AVE STE A
BOISE ID
83704-8320
US

V. Phone/Fax

Practice location:
  • Phone: 208-672-0260
  • Fax: 208-321-7750
Mailing address:
  • Phone: 208-672-0260
  • Fax: 208-321-7750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: BRADLEY MIDGETT
Title or Position: OWNER
Credential:
Phone: 208-672-0260