Organization
INNOVATIVE HEALTH CARE CONCEPTS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LONNA J. SMITH RN (ADMINISTRATOR)
(208) 529-8526
Entity
Organization
Contact information
Practice address
790 S HOLMES AVE, IDAHO FALLS, ID 83401-4749
(208) 529-8526
(208) 529-8597
Mailing address
790 S HOLMES AVE, IDAHO FALLS, ID 83401-4749
(208) 529-8526
(208) 529-8597
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002742000
—
ID
Enumeration date
05/25/2007
Last updated
06/02/2020
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