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General NPI Number Information
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NPI Number | 1912132176
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Entity Type | Organization
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Legal Business Name | INITIATIVES HEALTHCARE, LLC
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Dates
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Enumeration Date | 05/18/2009
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Last Update Date | 05/18/2009
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Provider Practice Location Address
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Address Line | 1205 N 11TH ST
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City | BOISE
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State | ID
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Zip | 83702-4102
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Country | US
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Telephone | 208-249-0011
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2775
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City | BOISE
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State | ID
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Zip | 83701-2775
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | BRENT CHERNE
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Credential | CPA
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Telephone | 208-939-2863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number |
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License Number State |
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