Healthcare Provider Details

I. General information

NPI: 1467377580
Provider Name (Legal Business Name): HOME CARE OF IDAHO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N PHILLIPPI ST
BOISE ID
83706-1419
US

IV. Provider business mailing address

101 N PHILLIPPI ST
BOISE ID
83706-1419
US

V. Phone/Fax

Practice location:
  • Phone: 208-807-4574
  • Fax:
Mailing address:
  • Phone: 208-807-4574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DANIEL BRIAN FRIESEN
Title or Position: OWNER/CO-FOUNDER
Credential:
Phone: 208-807-4574