Mycellia Cole-Thurow

Individual provider Active NPI In Home Supportive Care Agency · Boise, ID

NPI 1114747250 · NPPES record last updated Oct 14, 2024

Key facts

NPI
1114747250
Entity type
Individual (NPI type 1)
Primary specialty
In Home Supportive Care Agency 253Z00000X
Practice address
6006 W Rowan St
Boise, ID 83714-5138
Phone
(208) 590-1278
NPI assigned
Oct 14, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Yes

Addresses

Primary practice location

6006 W Rowan St
Boise, ID 83714-5138

Mailing address

6006 W Rowan St
Boise, ID 83714-5138

Other providers in Boise, ID

All providers in Boise, ID · In Home Supportive Care Agency in Idaho

Sources for this page

Verify at the official NPI Registry.