Provider Demographics
NPI:1134703085
Name:PLS CARE IMPACT LLC
Entity Type:Organization
Organization Name:PLS CARE IMPACT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PASCAL
Authorized Official - Middle Name:BISIMWA
Authorized Official - Last Name:RUDAHINDWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-246-9902
Mailing Address - Street 1:9131 W CORY LN APT 1
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-6423
Mailing Address - Country:US
Mailing Address - Phone:208-246-9902
Mailing Address - Fax:
Practice Address - Street 1:9428 W FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8101
Practice Address - Country:US
Practice Address - Phone:208-246-9902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care