Healthcare Provider Details

I. General information

NPI: 1790640480
Provider Name (Legal Business Name): ABUNDANCE LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9492 W FAIRVIEW AVE
BOISE ID
83704-8101
US

IV. Provider business mailing address

9492 W FAIRVIEW AVE
BOISE ID
83704-8101
US

V. Phone/Fax

Practice location:
  • Phone: 208-440-6545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State

VIII. Authorized Official

Name: EVERLINE MORAA NYAKUNDI
Title or Position: OWNER
Credential:
Phone: 208-912-5424