Organization
ACES
Active
Other names
Pioneer Health Resources
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD GROSS (OWNER)
(208) 322-1026
Entity
Organization
Contact information
Practice address
890 N. COLE RD., BOISE, ID 83704
(208) 322-1026
(208) 322-1029
Mailing address
890 N. COLE RD., BOISE, ID 83704
(208) 322-1026
(208) 322-1029
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8073861
BOISE-PSR
ID
Enumeration date
04/25/2007
Last updated
09/30/2011
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