Healthcare Provider Details

I. General information

NPI: 1891619748
Provider Name (Legal Business Name): LIFETIME OF LOVE NANNIES BOISE - LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1343 GRANITE LOOP RD
ATHOL ID
83801-8259
US

IV. Provider business mailing address

784 S CLEARWATER LOOP
POST FALLS ID
83854-9599
US

V. Phone/Fax

Practice location:
  • Phone: 208-279-3235
  • Fax:
Mailing address:
  • Phone: 208-279-3235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MARIAH MEYER
Title or Position: OPERATIONS ADMINISTRATOR
Credential:
Phone: 208-279-3235