Organization
BENEVOLENT ASSISTED LIVING LLC
Active
Other names
Brooklyn House, Heirloom House
Organization subpart
No
Provider details
NPI number
Authorized official
DARRYL RAY RUFFNER (OWNER/ADMINISTRATOR)
(208) 813-6449
Entity
Organization
Contact information
Practice address
9976 W PATTIE DR, BOISE, ID 83704-2900
(208) 813-6449
(208) 813-6462
Mailing address
1532 W POWDER CT, EAGLE, ID 83616-4876
(986) 888-7684
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
315D00000X
Inpatient Hospice
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DITPID018229
—
ID
Enumeration date
10/27/2022
Last updated
07/01/2023
Update your record
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