Provider Demographics
NPI:1447005913
Name:SAFARI HEALTH SERVICES
Entity type:Organization
Organization Name:SAFARI HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAFARI
Authorized Official - Suffix:
Authorized Official - Credentials:CPSS
Authorized Official - Phone:208-992-6510
Mailing Address - Street 1:5120 DALLASTOWN ST
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83605-5880
Mailing Address - Country:US
Mailing Address - Phone:208-992-6510
Mailing Address - Fax:
Practice Address - Street 1:8601 W EMERALD ST STE 160
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8297
Practice Address - Country:US
Practice Address - Phone:208-992-6510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-18
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty