Provider Demographics
NPI:1154296663
Name:ANGELS OF IDAHO
Entity type:Organization
Organization Name:ANGELS OF IDAHO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:B
Authorized Official - Last Name:DAWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-290-3999
Mailing Address - Street 1:7330 W SWIFT LN
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-5962
Mailing Address - Country:US
Mailing Address - Phone:626-290-3999
Mailing Address - Fax:626-290-3999
Practice Address - Street 1:7330 W SWIFT LN
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-5962
Practice Address - Country:US
Practice Address - Phone:626-290-3999
Practice Address - Fax:626-290-3999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health