NPI 1366811267

Celebrate Life Wellness

Organisation Preferred Provider Organization Boise, ID

Practice location

Address: 7750 W Crestwood Dr, Boise, ID 83704-3000
Phone: (208) 376-5433

Authorised official

Name: Tiffany Gauron
Title: Office Manager
Phone: (208) 376-5433

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence C0610 (ID)

Other Preferred Provider Organization providers in Idaho →

Registry record

NPI: 1366811267
Entity type: Organization
NPI issued: 21 Sep 2015
Record last updated: 21 Sep 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.