NPIMap

Organization Active NPI

Celebrate Life Wellness Center, LLC

  • Chiropractor
  • Boise, ID
National Provider Identifier
1942407333
Registry record updated Apr 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA428 Issued in ID
Legal business name
CELEBRATE LIFE WELLNESS CENTER, LLC
Practice address
7750 W Crestwood Drive #1
Boise, ID 83704
Phone
(208) 376-5433
Fax
(208) 376-5636
NPI assigned
Jun 28, 2007
Last updated
Apr 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2016

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

Authorized official

Name
Rebecca A BreshearsNPI 1659740553
Title
Owner
Phone
(208) 866-1490

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA428 ID Primary

Addresses

Primary practice location

7750 W Crestwood Drive #1
Boise, ID 83704

Mailing address

7750 W Crestwood Drive #1
Boise, ID 83704
Phone (208) 376-5433

Other names 1

  • Breshears Chiropractic Life Center Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Breshears Chiropractic Life Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7750 W Crestwood Dr
Ste 1
Boise, ID 83704
Phone (208) 376-5400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461715200000",
    "number": "1942407333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7750 W CRESTWOOD DRIVE #1",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-376-5433",
            "fax_number": "208-376-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7750 W CRESTWOOD DRIVE #1",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-376-5433",
            "fax_number": "208-376-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CELEBRATE LIFE WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2016-04-27",
        "status": "A",
        "authorized_official_last_name": "BRESHEARS",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-866-1490"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Breshears Chiropractic Life Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2016; 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.