Individual
DEBORAH JEAN JACOBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
115 W WILLOWAY DR, BOISE, ID 83705-5937
(208) 345-6625
Mailing address
3930 W PINE AVE, BOISE, ID 83703-4850
(208) 608-6114
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
ID
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
12/15/2020
Last updated
12/15/2020
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