Organization
LIFEPATH SUPPORTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANEY GILES BA (PAYEE PROVIDER)
(208) 780-3900
Entity
Organization
Contact information
Practice address
10112 W OVERLAND RD, BOISE, ID 83709-1428
(208) 780-3902
Mailing address
10112 W OVERLAND RD, BOISE, ID 83709-1428
(208) 780-3900
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/27/2015
Last updated
07/21/2022
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