Organization
GEMBA BOISE LLC
Active
Other names
Gemba Boise
Organization subpart
No
Provider details
NPI number
Authorized official
DAMON BERNARD ZIMMERMAN MA, MBA (OWNER)
(208) 830-8697
Entity
Organization
Contact information
Practice address
161 E MALLARD DR STE 110, BOISE, ID 83706-5015
(208) 830-8697
Mailing address
161 E MALLARD DR STE 110, BOISE, ID 83706-5015
(208) 830-8697
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
—
—
225X00000X
Occupational Therapist
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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