# COMPLETE CARE AUDIOLOGY INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Boise Speech and Hearing Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770539694
- **Authorized official:** BREK D STOKER AUD CCCA (OWNER)
- **Authorized official phone:** (208) 376-3591

## Contact information

- **Practice address:** 13176 PERSIMMON LN, \# 120, BOISE, ID 83713-1986
- **Practice address phone:** (208) 376-3591
- **Practice address fax:** (208) 376-3594
- **Mailing address:** 13176 PERSIMMON LN, \# 120, BOISE, ID 83713-1986
- **Mailing address phone:** (208) 376-3591
- **Mailing address fax:** (208) 376-3594

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | H412 | ID | Yes |

## Other

- **Enumeration date:** 05/25/2006
- **Last updated:** 04/02/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000010143633 | BLUE SHIELD OF IDAHO | ID |
| 01 | — | AU191 | BLUE CROSS | ID |