Organization
4MAPLE HAVEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERDINAND NYABENDA (OWNER)
(208) 936-0670
Entity
Organization
Contact information
Practice address
9492 W FAIRVIEW AVE, BOISE, ID 83704-8101
(208) 936-0670
Mailing address
9492 W FAIRVIEW AVE, BOISE, ID 83704-8101
(208) 936-0670
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/18/2025
Last updated
11/04/2025
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