Organization
SWAN LAKE LIVING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADAM ALI MD (CEO / DIRECTOR)
(208) 999-6555
Entity
Organization
Contact information
Practice address
106 N LATAH ST UNIT D, BOISE, ID 83706-2624
(208) 999-6555
(208) 473-4506
Mailing address
106 N LATAH ST UNIT D, BOISE, ID 83706-2624
(208) 999-5444
(208) 473-4506
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
11/12/2025
Last updated
02/08/2026
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