Healthcare Provider Details

I. General information

NPI: 1780482935
Provider Name (Legal Business Name): BEEHIVE ACADEMY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5895 S HARRINGTON WAY
BOISE ID
83709-6096
US

IV. Provider business mailing address

5895 S HARRINGTON WAY
BOISE ID
83709-6096
US

V. Phone/Fax

Practice location:
  • Phone: 801-403-1034
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA IMGRUND
Title or Position: OWNER
Credential:
Phone: 630-240-4437