| Organization Name: | BOISE MEMORIAL HOSPICE LLC |
| NPI Number: | 1144223900 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LAURIE KAY CAMPBELL (OWNER/DIRECTOR) |
| Mailing Address: | 600 E State St Suite 300 Eagle |
| State: | ID US |
| Postal Code: | 836166081 |
| Phone Number: | 2089384100 |
| Fax Number: | 2089384564 |
| NPI Enumeration Date: | 05/24/2005 |
| NPI Last Update Date: | 05/20/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |