Organization
ST. AUGUSTINE HEALTHCARE OF IDAHO LLC
Active
Organization
ST. AUGUSTINE HEALTHCARE OF IDAHO LLC
Active
Other names
St. Augustine Healthcare of Idaho
Organization subpart
No
Provider details
NPI number
Authorized official
ZIZINA ANACKER (OWNER)
(208) 202-8974
Entity
Organization
Contact information
Practice address
10936 W SPRING RIVER ST, BOISE, ID 83709-5677
(208) 202-8974
Mailing address
10936 W SPRING RIVER ST, BOISE, ID 83709-5677
(208) 202-8974
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
06/21/2023
Last updated
06/21/2023
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