BRENDA ELAINE DILBECK NPI 1861742736

NPI Information

NPI: 1861742736
Provider Name: BRENDA ELAINE DILBECK
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Individual
Address:
4515 N GLENWOOD ST
BOISE, ID
ZIP 83704
Phone: (208) 629-4290
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Brenda Elaine Dilbeck is an intermediate care facility mentally retarded in Boise, ID. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. Brenda Elaine Dilbeck NPI is 1861742736. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4515 N GLENWOOD ST
BOISE, ID
ZIP 83704-012
Phone: (208) 629-4290
Fax: (208) 629-4290

The enumeration date for this NPI number is 9/18/2012 and was last updated on 9/18/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	M8063096	MEDICAID	IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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