Healthcare Provider Details

I. General information

NPI: 1942145289
Provider Name (Legal Business Name): AFFINITY CARE OF IDAHO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 W BANNOCK ST STE 1100
BOISE ID
83702-6140
US

IV. Provider business mailing address

950 W BANNOCK ST STE 1100
BOISE ID
83702-6140
US

V. Phone/Fax

Practice location:
  • Phone: 208-460-5900
  • Fax: 208-485-7093
Mailing address:
  • Phone: 208-460-5900
  • Fax: 208-485-7093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL STERN
Title or Position: CEO
Credential:
Phone: 510-499-9977