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CORBETT SOUSA NPI 1417442484


NPI Information

NPI: 1417442484
Provider Name: CORBETT SOUSA

Other Name: ACHIEVING FAMILY WELLNESS LLC

Classification: Point of Service - 305S00000X
Entity Type: Organization
Address:
16 12TH AVE S STE 208
NAMPA, ID
ZIP 83651
Phone: (208) 649-6048
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CORBETT SOUSA is a point of service in Nampa, ID. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. CORBETT SOUSA NPI is 1417442484. The provider is registered as an organization entity type.
The provider Other Name Is Achieving Family Wellness Llc.

The provider's business location address is:

16 12TH AVE S STE 208
NAMPA, ID
ZIP 83651-937
Phone: (208) 649-6048
Fax: (208) 906-2343

The provider's authorized official is Katy Simmons .
The authorized official title is Credentialing/billing and has the following contact phone number (208) 452-6580.

The enumeration date for this NPI number is 6/22/2018 and was last updated on 6/22/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1305S00000XPoint of Service37239IDAHOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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