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General NPI Number Information
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NPI Number | 1891619748
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Entity Type | Organization
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Legal Business Name | LIFETIME OF LOVE NANNIES BOISE - LLC
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 1343 GRANITE LOOP RD
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City | ATHOL
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State | ID
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Zip | 83801-8259
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Country | US
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Telephone | 208-279-3235
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Fax |
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Provider Business Mailing Address
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Address Line | 784 S CLEARWATER LOOP
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City | POST FALLS
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State | ID
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Zip | 83854-9599
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Country | US
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Telephone | 208-279-3235
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Fax |
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Authorized Official
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Title or Position | OPERATIONS ADMINISTRATOR
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Name | MARIAH MEYER
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Credential |
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Telephone | 208-279-3235
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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