Bronco Senior Services

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

RC-998 Issued in ID

Legal business name

BRONCO SENIOR SERVICES

Doing business as

Hillcrest

Practice address

1093 S Hilton St
Boise, ID 83705-1971

Phone

(208) 345-4460

NPI assigned

Dec 5, 2011

Last updated

Dec 6, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ricky Haskell

Title

Manager

Phone

(720) 257-2366

Specialties & licenses 1

Addresses

Other names 1

• Hillcrest Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323129600000",
    "number": "1821366998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1093 S HILTON ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051971",
            "telephone_number": "208-345-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1093 S HILTON ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051971",
            "telephone_number": "208-345-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRONCO SENIOR SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-05",
        "last_updated": "2011-12-06",
        "status": "A",
        "authorized_official_last_name": "HASKELL",
        "authorized_official_first_name": "RICKY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "720-257-2366"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "ID",
            "license": "RC-998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hillcrest",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Seiji Brock, LCPC
• Debra Jean Brockert, LMSW
• Daniel J Broderick, DO
• Melva June Broderick, R.N.
• Thomas W Broderick, M.D.
• Jason Bronner, MD
• Tina Esther G Bronner, MD
• Brookdale Dental, PA
• Brookdale Senior Living Communities, Inc. (Brookdale Boise Parkcenter)
• Allison Brookins, MPT

• Assisted Living Facility in Boise, ID
• Providers in Boise, ID by specialty
• Assisted Living Facility in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.