Healthcare Provider Details

I. General information

NPI: 1821902818
Provider Name (Legal Business Name): IDAHO HOME LEARNING ACADEMY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 S 300 E
MALAD CITY ID
83252-1343
US

IV. Provider business mailing address

195 S 300 E
MALAD CITY ID
83252-1343
US

V. Phone/Fax

Practice location:
  • Phone: 208-534-6080
  • Fax: 208-550-3825
Mailing address:
  • Phone: 208-534-6080
  • Fax: 208-550-3825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JILL DANIELS
Title or Position: SPECIAL EDUCATION DIRECTOR
Credential: ME
Phone: 208-534-6080