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General NPI Number Information
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NPI Number | 1598975658
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Entity Type | Organization
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Legal Business Name | INNOVATIVE HEALTH CARE CONCEPTS, INC
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 1545 S BOULEVARD
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City | IDAHO FALLS
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State | ID
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Zip | 83404-5926
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Country | US
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Telephone | 208-552-1016
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Fax | 208-552-1812
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Provider Business Mailing Address
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Address Line | 790 S HOLMES AVE
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City | IDAHO FALLS
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State | ID
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Zip | 83401-4749
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Country | US
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Telephone | 208-529-8526
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Fax | 208-529-8597
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. LONNA J. SMITH
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Credential | RN
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Telephone | 208-529-8526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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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 | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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