Healthcare Provider Details

I. General information

NPI: 1598553836
Provider Name (Legal Business Name): ROCK BOTTOM RECOVERY AND TREATMENT SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9492 W FAIRVIEW AVE
BOISE ID
83704-8101
US

IV. Provider business mailing address

9492 W FAIRVIEW AVE
BOISE ID
83704-8101
US

V. Phone/Fax

Practice location:
  • Phone: 208-440-6545
  • Fax:
Mailing address:
  • Phone: 208-440-6545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: DUKE NYARECHA
Title or Position: PARTNER
Credential: DNP
Phone: 208-440-6545