Organization
BOUNDARY REGIONAL COMMUNITY HEALTH CENTER, INC.
Active
Other names
Kaniksu Community Health
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN KNEPPER (CHIEF EXECUTIVE OFFICER)
(208) 263-3410
Entity
Organization
Contact information
Practice address
1033 BALDY MOUNTAIN RD, SANDPOINT, ID 83864-9202
(208) 263-7101
(208) 263-7198
Mailing address
PO BOX 2160, SANDPOINT, ID 83864-0908
(208) 263-3410
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8065901
—
ID
01
—
DB1056
RAILROAD MEDICARE
—
Enumeration date
01/02/2007
Last updated
09/24/2024
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