LIVE WELL HEALTH AND NUTRITION PLLC (NPI# 1952815623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952815623 |
| Entity Type | Organization |
| Organization Name | LIVE WELL HEALTH AND NUTRITION PLLC |
| Practice Address |
4700 N Cloverdale Rd Ste 103 Boise ID 83713-1067 |
| Practice Telephone | 2083928383 |
| Practice Fax Number | 2084933062 |
| Mailing Telephone | 2083928383 |
| Mailing Fax Number | 2084933062 |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2017-11-16 |
| Authorized Official Name | DENISE BAHADAR (NP, OWNER) |
| Authorized Official Telephone | 2088614677 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | STATE LICENSE | NP-1169A | 01 |
| Street Address |
4700 N CLOVERDALE RD STE 103 |
| City | BOISE |
| State | ID |
| Zip Code | 83713-1067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285658302 | Blake Louis Howard | Chiropractor | 4700 N Cloverdale Rd Ste 103, Boise, ID 83713-1067 | 2006-07-26 |
| 1760845259 | Jill Moughamian | Nurse Practitioner | 4700 N Cloverdale Rd Ste 103, Boise, ID 83713-1067 | 2016-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265902332 | Kidscare Home Health of Idaho, LLC | Home Health | 1835 Wildwood Street, Boise, ID 83713 | 2018-11-30 |
| 1417463928 | Kimberly Ann Bohrer | Behavioral Analyst | 12053 W Hickory Dr, Boise, ID 83713 | 2017-12-19 |
| 1407371891 | Emir Hadzic | Optometrist | 13239 W. Fernleaf St., Boise, ID 83713 | 2017-08-07 |
| 1518336650 | Alliance Physical Medicine | Nurse Practitioner | 13909 W Wainwright Drive, Boise, ID 83713 | 2015-09-18 |
| 1083038335 | Jan L Rehder | Nurse Practitioner | 13150 W Persimmon Lane, Boise, ID 83713 | 2014-02-06 |
| 1508287061 | Heather N Fox | Physician Assistant | 12273 West Mcmillan Road, Boise, ID 83713 | 2013-12-30 |
| 1659667459 | Jayson Clark | Dentist | 4274 N Eagle Road, Boise, ID 83713 | 2011-06-21 |
| 1043503659 | Steven Anthony Eckhoff | Physician Assistant | 11662 W Arlen St, Boise, ID 83713 | 2011-05-16 |
| 1790923621 | Christie Dudash Flynn | Physician Assistant | 12273 W Mcmillian Road, Boise, ID 83713 | 2009-01-30 |
| 1699930404 | Dennis J. Garpetti, Dds, P.C. | Dentist | 13108 West Persimmon Lane, Boise, ID 83713 | 2008-07-21 |
| Find all providers in zip 83713 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124674437 | Michael J. Moorhouse Inc. | Clinic/Center | 13900 W Wainwright Dr Ste 100, Boise, ID 83713-5028 | 2019-08-13 |
| 1528623915 | D & S Works | Clinic/Center | 5622 W State St, Boise, ID 83703-3010 | 2019-05-01 |
| 1114432689 | Triton Elite Athletic Medicine | Clinic/Center | 2392 E Gowen Rd, Boise, ID 83716-6707 | 2017-12-06 |
| 1093034936 | Marston Family Chiropractic Pllc | Clinic/Center | 5275 S Deselm Way, Boise, ID 83716-6904 | 2010-05-17 |
| 1811101942 | Laser Vision Centers, Inc. | Clinic/Center | 7960 West Rifleman Street, Ste. 150, Boise, ID 83704 | 2007-05-09 |
| 1447376355 | Planned Parenthood of Idaho | Clinic/Center | 3668 N Harbor Lane, Boise, ID 83703 | 2007-03-22 |
| 1568587707 | Therapy Express Pa | Clinic/Center | 8024 W Scardale Ct, Boise, ID 83704-0713 | 2007-03-20 |
| 1548811441 | Catalyst Acupuncture & Integrative Medicine | Clinic/Center | 4477 W Emerald St Ste A150, Boise, ID 83706-2027 | 2019-09-23 |
| 1255985321 | Cde Services | Clinic/Center | 13150 W Persimmon Ln, Boise, ID 83713-1986 | 2019-07-27 |
| 1760920631 | Oakes Chiropractic Health Center P A | Clinic/Center | 3183 N Cole Rd, Boise, ID 83704-5921 | 2017-02-10 |
| Find all providers in BOISE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.