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Individual

JAMES COPELAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
16557 SPARTAN AVE, CALDWELL, ID 83607-5224
(208) 353-1530
Mailing address
16557 SPARTAN AVE, CALDWELL, ID 83607-5224
(208) 353-1530

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
CFH-5972
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
A0002760
ID
Enumeration date
05/13/2025
Last updated
05/13/2025
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