Healthcare Provider Details

I. General information

NPI: 1992528806
Provider Name (Legal Business Name): HUMMINGBIRD VENTURES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2024
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13423 W ELMSPRING DR
BOISE ID
83713-1322
US

IV. Provider business mailing address

1920 E DAULBY ST
MERIDIAN ID
83642-9174
US

V. Phone/Fax

Practice location:
  • Phone: 208-999-7678
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY KINSHELLA
Title or Position: OWNER
Credential:
Phone: 208-954-2650