Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Center for Lifetime Health

Organization Family Medicine Physician · NPI 1689744963

Center for Lifetime Health is a Family Medicine Physician in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2006.

Licensed in
ID
In the registry since
2006

Practice location Address checks out

300 E Bannock St
Boise, ID 83712
Phone: (208) 342-7400
Fax: (208) 342-1879
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence M5741 (ID)

Record details

NPI number1689744963
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Colleen Shackelford — Owner · (208) 342-7400
Other names Colleen Shackelford, Llc
NPI enumeratedNovember 8, 2006
Last updated in NPPESJuly 25, 2023
Certification dateJuly 25, 2023
Mailing address300 E Bannock St, Boise, ID 83712

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