Organization
BOISE GROUP HOMES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD DAVIS (ADMINISTRATOR)
(208) 376-1861
Entity
Organization
Contact information
Practice address
8310 USTICK RD, BOISE, ID 83704-5757
(208) 376-1861
(208) 376-1869
Mailing address
PO BOX 4243, BOISE, ID 83711-4243
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
58
ID
Other
Enumeration date
02/05/2007
Last updated
08/22/2020
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