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General NPI Number Information
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NPI Number | 1184262487
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Entity Type | Organization
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Legal Business Name | WE CARE WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 12/17/2019
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 827 W PRAIRIE AVE
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City | HAYDEN
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State | ID
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Zip | 83835-8459
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Country | US
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Telephone | 208-967-5608
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Fax |
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Provider Business Mailing Address
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Address Line | 827 W PRAIRIE AVE
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City | HAYDEN
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State | ID
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Zip | 83835-8459
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Country | US
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Telephone | 208-967-5608
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ERIC J BACKMAN
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Credential |
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Telephone | 208-660-9378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2251C2600X
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Taxonomy Name | Cardiopulmonary Physical Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2251N0400X
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Taxonomy Name | Neurology Physical Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 261QV0200X
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Taxonomy Name | VA Clinic/Center
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License Number |
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License Number State |
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