Organization
HISWAY, LLC
Active
Other names
Hisway, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELLEN MARIE HAMPTON (ADMINISTRATOR/OWNER)
(208) 860-7124
Entity
Organization
Contact information
Practice address
8590 W FAIRVIEW AVE, BOISE, ID 83704-8320
(208) 860-7124
(208) 672-0238
Mailing address
8590 W FAIRVIEW AVE, BOISE, ID 83704-8320
(208) 860-7124
(208) 672-0238
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
LCSW820
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770917866
—
ID
Enumeration date
08/26/2013
Last updated
07/14/2022
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