Healthcare Provider Details

I. General information

NPI: 1760283493
Provider Name (Legal Business Name): RUBATO RELATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2025
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6126 W STATE ST # 307
BOISE ID
83703-2741
US

IV. Provider business mailing address

104 E FAIRVIEW AVE # 217
MERIDIAN ID
83642-1733
US

V. Phone/Fax

Practice location:
  • Phone: 651-428-0274
  • Fax:
Mailing address:
  • Phone: 651-428-0274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH ANOMALAY
Title or Position: OWNER/CLINCIAN
Credential: LCPC-7328
Phone: 651-428-0274