Organization
HEARTFELT HAVEN ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDEN TESH BLACK RN, BSN, MBA (OWNER)
(208) 316-7357
Entity
Organization
Contact information
Practice address
1212 S LONGMONT AVE, BOISE, ID 83706-3645
(208) 316-7357
Mailing address
1212 S LONGMONT AVE, BOISE, ID 83706-3645
(208) 316-7357
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
04/09/2026
Last updated
04/16/2026
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