Organization · NPI-2

Adolpho Enterprise LLC.

Clinic/Center, Mental Health (Including Community Mental Health Center) · Boise, ID

NPI number1063340586
StatusActive
Last updated in NPPESMay 13, 2026

Details

NPI
1063340586
Entity type
Organization (NPI-2)
Legal business name
Adolpho Enterprise LLC.
Organization subpart
No
Enumeration date
May 13, 2026
Certification date
May 13, 2026
Last updated
May 13, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder––

Practice location

3649 N Lakeharbor Ln
Boise, ID 83703-6913

Phone 208-991-4296

Mailing address

3649 N Lakeharbor Ln
Boise, ID 83703-6913

Other practice locations

411 W 7200 S Ste 104
Midvale, UT 84047-1014

Phone 385-404-4296 · Fax 385-404-4296

Authorized official

Rick Adolpho
Co-Owner
2089914296

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