Provider Demographics
NPI:1821899501
Name:TREASURE VALLEY HOSPICE LLC
Entity type:Organization
Organization Name:TREASURE VALLEY HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:208-577-8672
Mailing Address - Street 1:5108 N MAIDSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-1367
Mailing Address - Country:US
Mailing Address - Phone:208-577-8672
Mailing Address - Fax:208-209-6058
Practice Address - Street 1:5108 N MAIDSTONE WAY
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713-1367
Practice Address - Country:US
Practice Address - Phone:208-577-8672
Practice Address - Fax:208-209-6058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community Based
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty