ESSENTIAL LIFE BOISE, LLC – NPI #1669727400
Clinic/Center

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

ESSENTIAL LIFE BOISE, LLC is an AHC clinic located in BOISE, ID. NPPES has assigned the NPI number 1669727400 to ESSENTIAL LIFE BOISE, LLC on July 18, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QM2500X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Medical Specialty

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ESSENTIAL LIFE BOISE, LLC below.

NPI Profile for
ESSENTIAL LIFE BOISE, LLC

NPI Number
1669727400
Enumeration Date

(about 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ESSENTIAL LIFE BOISE, LLC
Primary location
13125 W PERSIMMON LN
SUITE 100
BOISE, ID 83713
Phone: (208) 991-0352 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
YVONNE FEDEWA
OWNER
Phone: (208) 991-0352
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM2500X
- Clinic/Center / Medical Specialty (Primary)
ID CHIA1466

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.