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General NPI Number Information
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NPI Number | 1013317064
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Entity Type | Organization
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Legal Business Name | COMPLETE HOSPICE CARE OF BOISE LLC
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Dates
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Enumeration Date | 08/27/2014
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Last Update Date | 01/08/2020
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Provider Practice Location Address
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Address Line | 1940 S BONITO WAY STE 140
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City | MERIDIAN
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State | ID
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Zip | 83642-2625
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Country | US
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Telephone | 208-391-2724
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Fax |
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Provider Business Mailing Address
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Address Line | 7558 W THUNDERBIRD RD # 493
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City | PEORIA
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State | AZ
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Zip | 85381-6080
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Country | US
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Telephone | 208-391-2724
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Fax | 888-858-4402
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Authorized Official
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Title or Position | BUSINESS PARTNER
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Name | CHARLOTTE IGO
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Credential |
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Telephone | 208-391-2724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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