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Organization

NVELUP IDAHO CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TROY DI LELLO (PRESIDENT)
(208) 510-6030
Entity
Organization

Contact information

Practice address
3597 E MONARCH SKY LN STE 240-8464, MERIDIAN, ID 83646-1053
(208) 510-6030
Mailing address
PO BOX 7221, PETALUMA, CA 94955-7221
(415) 324-9906

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary

Other

Enumeration date
03/31/2023
Last updated
03/28/2025
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