Organization
BOUNDARY REGIONAL COMMUNITY HEALTH CENTER, INC.
Active
Other names
Kaniksu Community Health
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN KNEPPER (CEO)
(208) 263-3410
Entity
Organization
Contact information
Practice address
6509 HIGHWAY 2, SUITE 101, PRIEST RIVER, ID 83856-6609
(208) 448-2321
(208) 448-1317
Mailing address
PO BOX 2160, SANDPOINT, ID 83864-0908
(208) 263-3410
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DB1056
RAILROAD MEDICARE
ID
Enumeration date
07/22/2011
Last updated
12/03/2021
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