Healthcare Provider Details

I. General information

NPI: 1861336992
Provider Name (Legal Business Name): NORTH IDAHO CLASSICAL ACADEMY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6672 RIVERSIDE STREET
BONNERS FERRY ID
83805
US

IV. Provider business mailing address

PO BOX 88
BONNERS FERRY ID
83805-0088
US

V. Phone/Fax

Practice location:
  • Phone: 208-614-2445
  • Fax:
Mailing address:
  • Phone: 208-614-2445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: DR. JACOB FRANCOM
Title or Position: HEAD OF SCHOOL
Credential:
Phone: 208-614-2445