Organization
TOWN PORTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL LARKIN (OWNER)
(208) 514-6630
Entity
Organization
Contact information
Practice address
1819 W BANNOCK ST, BOISE, ID 83702-5109
(208) 514-6630
Mailing address
1755 N WESTGATE DR STE 220, BOISE, ID 83704-7181
(208) 514-6630
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
311500000X
Alzheimer Center (Dementia Center)
—
—
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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