Organization · NPI-2

4maple Haven

Case Management · Boise, ID

NPI number1912873209
StatusActive
Last updated in NPPESNov 21, 2025

Details

NPI
1912873209
Entity type
Organization (NPI-2)
Legal business name
4maple Haven
Organization subpart
No
Enumeration date
Oct 14, 2025
Certification date
Nov 21, 2025
Last updated
Nov 21, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251B00000X Case Management––Yes
1041S0200X Social Worker, School––

Practice location

9492 W Fairview Ave
Boise, ID 83704-8101

Phone 208-936-0670

Mailing address

9492 W Fairview Ave
Boise, ID 83704-8101

Authorized official

Ferdinand Nyabenda
Owner
2089360670

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