Healthcare Provider Details

I. General information

NPI: 1912905100
Provider Name (Legal Business Name): REHAB SYSTEMS BOISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 N CURTIS RD
BOISE ID
83706-1439
US

IV. Provider business mailing address

427 N CURTIS RD
BOISE ID
83706-1439
US

V. Phone/Fax

Practice location:
  • Phone: 208-342-4104
  • Fax: 208-342-4106
Mailing address:
  • Phone: 208-342-4104
  • Fax: 208-342-4106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: COLETTE BROWN
Title or Position: ADMIN MANAGER
Credential:
Phone: 208-342-4104