Provider Demographics
NPI:1154647097
Name:BPA HEALTH
Entity type:Organization
Organization Name:BPA HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-947-1304
Mailing Address - Street 1:8050 W RIFLEMAN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-9006
Mailing Address - Country:US
Mailing Address - Phone:208-947-1320
Mailing Address - Fax:208-344-7430
Practice Address - Street 1:8050 W RIFLEMAN ST STE 100
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-9006
Practice Address - Country:US
Practice Address - Phone:208-947-1320
Practice Address - Fax:208-344-7430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-16
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)