Healthcare Provider Details

I. General information

NPI: 1841109394
Provider Name (Legal Business Name): BRENDA ROWLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 N SPICELAND DR
BOISE ID
83704-4152
US

IV. Provider business mailing address

3400 N SPICELAND DR
BOISE ID
83704-4152
US

V. Phone/Fax

Practice location:
  • Phone: 208-602-4945
  • Fax:
Mailing address:
  • Phone: 208-602-4945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: