Lifepath Supports INC

NPI #1164899951 in Boise, Idaho

Provider Information

NPI Number: 1164899951
Entity Type: Organization
Organization Name: Lifepath Supports INC
Primary Specialty: Clinic/Center
Enumeration Date: Aug 27, 2015
Last Updated: Jul 21, 2022

Practice Location

Address: 10112 W OVERLAND RD
City: Boise
State: Idaho
ZIP Code: 83709-1428
Phone: (208) 780-3902

Authorized Official

Name: TIFFANEY GILES, BA
Title: PAYEE PROVIDER
Phone: (208) 780-3900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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