Healthcare Provider Details

I. General information

NPI: 1174432314
Provider Name (Legal Business Name): FOSTERING HOPE HEALTH & DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3126 W PASCAL DR
COEUR D ALENE ID
83815-6111
US

IV. Provider business mailing address

3126 W PASCAL DR
COEUR D ALENE ID
83815-6111
US

V. Phone/Fax

Practice location:
  • Phone: 208-755-7617
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number StateNULL

VIII. Authorized Official

Name: GABRIEL FOSTER
Title or Position: FOUNDER, PRESIDENT & CEO
Credential: RT(R)
Phone: 208-755-7617