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
1545 S BOULEVARD, IDAHO FALLS, ID 83404-5926
(208) 552-1016
(208) 552-1812
Mailing address
790 S HOLMES AVE, IDAHO FALLS, ID 83401-4749
(208) 529-8526
(208) 529-8597
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806411700
—
ID
Enumeration date
05/23/2007
Last updated
05/14/2025
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