State Of Idaho

LBN: Southwest District Health
State Of Idaho is an health care organization with primary practice located at 13307 Miami Ln , Caldwell ID 83607-4701. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Allopathic & Osteopathic Physicians / Family Medicine, Agencies / Public Health or Welfare. Agencies / Public Health or Welfare is the primary health care specialty. Southwest District Health can be contacted via phone (208) 455-5305, or through Boster, Kelly S via phone (208) 455-5348.

Contact Information

Primary practice address
13307 Miami Ln Caldwell ID 83607-4701
Phone: (208) 455-5305
Fax: (208) 455-5368
Website:
Map and Directions
Authorized official contact:
Name: Boster, Kelly S
Phone: (208) 455-5348

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Agencies / Public Health or Welfare 251K00000X

Profile Details

NPI number 1598748337
LBN Legal business name Southwest District Health
DBA Doing business as State Of Idaho
Authorized official Boster, Kelly S
Entity Organization
Organization subpart 1 No
Enumeration date Nov 25th, 2005
Last updated Feb 2nd, 2024 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598748337 NPPES
Hawaii MEDICAID 002824100
Hawaii MEDICAID 002828400
Hawaii MEDICAID 002821600
Hawaii MEDICAID 805201700

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