# ALLEGIANT IDAHO, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285400713
- **Authorized official:** MRS. TRACY LOUISE BERRY (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (208) 466-0987

## Contact information

- **Practice address:** 210 12TH AVE RD, NAMPA, ID 83686-5013
- **Practice address phone:** (208) 466-0987
- **Practice address fax:** (208) 466-0985
- **Mailing address:** 119 S VALLEY DR \# 114, NAMPA, ID 83686-2974
- **Mailing address phone:** (208) 466-0987
- **Mailing address fax:** (208) 466-0985

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 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