# RJN BOISE, LLC

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

## Provider details

- **NPI number:** 1912575424
- **Authorized official:** RANDALL JEROME NILSON (MEMBER/MANAGER)
- **Authorized official phone:** (208) 409-8798

## Contact information

- **Practice address:** 2000 S PEPPERCORN PL, BOISE, ID 83709-2249
- **Practice address phone:** (208) 409-8798
- **Mailing address:** 2000 S PEPPERCORN PL, BOISE, ID 83709-2249
- **Mailing address phone:** (208) 409-8798

## Taxonomy

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

## Other

- **Enumeration date:** 06/12/2021
- **Last updated:** 06/12/2021