Healthcare Provider Details

I. General information

NPI: 1003734815
Provider Name (Legal Business Name): OVERCOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 E 43RD ST APT 408
GARDEN CITY ID
83714-4926
US

IV. Provider business mailing address

408 E 43RD ST APT 408
GARDEN CITY ID
83714-4926
US

V. Phone/Fax

Practice location:
  • Phone: 208-202-9347
  • Fax:
Mailing address:
  • Phone: 208-202-9347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name: MS. YOMIRRA AL TUSSA
Title or Position: CEO
Credential:
Phone: 208-202-9347