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General NPI Number Information
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NPI Number | 1578448643
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Entity Type | Organization
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Legal Business Name | SANOURA HAVEN LLC
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 01/18/2026
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Provider Practice Location Address
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Address Line | 110 12TH AVE S STE 201
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City | NAMPA
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State | ID
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Zip | 83651-3934
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Country | US
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Telephone | 208-402-8769
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Fax | 208-266-5610
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Provider Business Mailing Address
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Address Line | PO BOX 101
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City | NAMPA
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State | ID
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Zip | 83653-0101
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Country | US
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Telephone | 208-402-8769
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR, RN
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Name | KAITLIN PETERS
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Credential | RN
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Telephone | 208-402-8769
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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