Provider Demographics
NPI:1831957232
Name:INFINITY CARE AND SERVICES
Entity type:Organization
Organization Name:INFINITY CARE AND SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:OMOBOLANLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHAEL - EKPENKHIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-639-0126
Mailing Address - Street 1:2125 W OVERLAND RD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-3149
Mailing Address - Country:US
Mailing Address - Phone:208-639-0126
Mailing Address - Fax:
Practice Address - Street 1:2125 W OVERLAND RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-3149
Practice Address - Country:US
Practice Address - Phone:208-639-0126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care