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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
253Z00000X
In Home Supportive Care Agency
Primary
372500000X
Chore Provider
372600000X
Adult Companion
376J00000X
Homemaker

Other

Enumeration date
11/27/2023
Last updated
04/08/2025
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