# BOISE VA HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073616942
- **Authorized official:** MS. KATHLEEN BRUCE KELLEY OTR/L (OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (208) 422-1338

## Contact information

- **Practice address:** 500 W FORT ST, BOISE, ID 83702-4501
- **Practice address phone:** (208) 422-1338
- **Mailing address:** 801 W SANDSTONE LN, BOISE, ID 83702-6543
- **Mailing address phone:** (208) 338-5597

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | OT 147 | ID | Yes |

## Other

- **Enumeration date:** 09/06/2006
- **Last updated:** 06/16/2008