MEDICARE: LARKSPUR INTEGRATIVE HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1538001573
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LARKSPUR INTEGRATIVE HEALTH LLC

Provider Business Mailing Address
First Line	:	2659 N MERIDIAN RD
Second Line	:
City	:	EAGLE
State	:	ID
Zip	:	83616-3447
Country	:	US
Telephone Number	:	406-249-8205
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 E RIVERSIDE DR STE 100
Second Line	:
City	:	EAGLE
State	:	ID
Zip	:	83616-6088
Country	:	US
Telephone Number	:	208-430-9440
Fax Number	:

Authorized Official
Title or Position	:	NURSE PRACTITIONER AND FOUNDER
Name	:	MELANIE CHRISTINE MALTESE
Credential	:	FNP-C
Telephone Number	:	406-249-8205

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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