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Organization
ALLEGIANT IDAHO, LLC
Active
Organization
ALLEGIANT IDAHO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACY LOUISE BERRY (EXECUTIVE DIRECTOR)
(208) 466-0987
Entity
Organization
Contact information
Practice address
210 12TH AVE RD, NAMPA, ID 83686-5013
(208) 466-0987
(208) 466-0985
Mailing address
119 S VALLEY DR # 114, NAMPA, ID 83686-2974
(208) 466-0987
(208) 466-0985
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
372500000X
Chore Provider
—
NULL
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
NULL
372600000X
Adult Companion
—
—
376J00000X
Homemaker
—
NULL
376J00000X
Homemaker
—
—
Other
Enumeration date
11/27/2023
Last updated
04/08/2025
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