OrganizationActive
Broader Wellness, LLC
NPI 1689480030 · Mental Health Clinic/Center (Including Community Mental Health Center) · Boise, ID
Provider details
- NPI number
- 1689480030
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Stacey Martinez, LLC Member/Manager(986) 279-3252
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
3350 W Americana Ter Ste 210a
Boise, ID 83706-2521
Phone: (986) 279-3252
Fax: (208) 908-0034
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 6421
Boise, ID 83707-6421
Registry dates
- Enumerated
- 2024-12-09
- Last updated
- 2024-12-09
- Certified
- 2024-12-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.