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Contact Information

IDAHO MEMORY & AGING CENTER PLLC
413 N ALLUMBAUGH ST
STE# 101
BOISE, ID83704-9212
 Phone: 617-922-4957
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for IDAHO MEMORY & AGING CENTER PLLC

NPI Number 1730528548
LBN Legal business name IDAHO MEMORY & AGING CENTER PLLC
Authorized official ABHILASH DESAI - (MEDICAL DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 06/14/2013
Last updated 07/19/2013 - About 13 years ago
Identifiers
ID License # M-12079
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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