Healthcare Provider Details

I. General information

NPI: 1194046367
Provider Name (Legal Business Name): IDAHO PARTNERS IN CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2010
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 ELM DR
ST MARIES ID
83861-2119
US

IV. Provider business mailing address

820 ELM DR
ST MARIES ID
83861-2119
US

V. Phone/Fax

Practice location:
  • Phone: 208-245-4576
  • Fax: 208-245-2138
Mailing address:
  • Phone: 208-245-4576
  • Fax: 208-245-2138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State

VIII. Authorized Official

Name: KASEY BORGMAN
Title or Position: CORPORATE COMPLIANCE
Credential:
Phone: 208-245-4576