Provider Demographics
NPI:1831879188
Name:NIGUEL SANTE LLC
Entity type:Organization
Organization Name:NIGUEL SANTE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KINDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAGARIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-948-3875
Mailing Address - Street 1:PO BOX 2132
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83403-2132
Mailing Address - Country:US
Mailing Address - Phone:208-715-5500
Mailing Address - Fax:
Practice Address - Street 1:1950 1ST ST
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83401-4342
Practice Address - Country:US
Practice Address - Phone:208-715-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-21
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility