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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