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General NPI Number Information
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NPI Number | 1427419647
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Entity Type | Organization
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Legal Business Name | A L P H A CARE
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Dates
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Enumeration Date | 03/15/2016
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 537 W BANNOCK ST STE 100
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City | BOISE
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State | ID
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Zip | 83702-5759
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Country | US
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Telephone | 208-424-7799
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Fax | 208-629-1260
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Provider Business Mailing Address
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Address Line | 537 W BANNOCK ST STE 100
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City | BOISE
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State | ID
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Zip | 83702-5759
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Country | US
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Telephone | 208-424-7799
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | CHRISTOPHER BIDIMAN
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Credential | RN, BSN
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Telephone | 208-596-2701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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 #3
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Taxonomy Code | 363LC1500X
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Taxonomy Name | Community Health Nurse Practitioner
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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