Organization
HAVENWOOD CAREGIVER SERVICES OF IDAHO, LLC
Active
Other names
Abundant Care by Havenwood
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN OKEEFFE (DIRECTOR)
(208) 327-1011
Entity
Organization
Contact information
Practice address
2417 N COLE RD, BOISE, ID 83704-5907
(208) 327-1011
(208) 327-1411
Mailing address
2417 N COLE RD, BOISE, ID 83704-5907
(208) 327-1011
(208) 327-1411
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M8072875
—
ID
Enumeration date
01/24/2018
Last updated
01/26/2018
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