# AMBITIONS OF IDAHO, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** AMBITIONS OF IDAHO, INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1750012399
- **Legal business name:** AMBITIONS OF IDAHO, INC
- **Authorized official:** SHANE HAGEL (PRESIDENT)
- **Authorized official phone:** (208) 676-9395

## Contact information

- **Practice address:** 1019 W SANETTA ST, NAMPA, ID 83651-5047
- **Practice address phone:** (208) 505-9076
- **Practice address fax:** (208) 505-9077
- **Mailing address:** 1044 NORTHWEST BLVD STE F, COEUR D ALENE, ID 83814-2165
- **Mailing address phone:** (208) 676-9395
- **Mailing address fax:** (208) 676-9385

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 06/23/2022
- **Last updated:** 06/23/2022