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General NPI Number Information
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NPI Number | 1386553428
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Entity Type | Individual
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Provider Name | YAKOBO N RUTEBUKA
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Gender | Male
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Dates
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Enumeration Date | 09/03/2026
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Last Update Date | 09/03/2026
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Provider Practice Location Address
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Address Line | 9428 W FAIRVIEW AVE
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City | BOISE
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State | ID
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Zip | 83704-8101
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Country | US
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Telephone | 986-301-0460
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Fax |
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Provider Business Mailing Address
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Address Line | 3125 S APPLE ST APT 101
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City | BOISE
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State | ID
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Zip | 83706-6818
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Country | US
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Telephone | 986-268-6362
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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