Coralvita Boise, LLC

Primary specialty

Long Term Care HospitalTaxonomy code 282E00000X

Legal business name

CORALVITA BOISE, LLC

Practice address

6651 W Franklin Rd
Boise, ID 83709-0914

Phone

(208) 459-9500

NPI assigned

Sep 18, 2025

Last updated

Sep 18, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Anis Sabeti

Title

Chief Executive Officer

Phone

(972) 567-4932

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1758153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1720950090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 LAS COLINAS BLVD E",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750395579",
            "telephone_number": "972-567-4932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6651 W FRANKLIN RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837090914",
            "telephone_number": "208-459-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORALVITA BOISE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-18",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A",
        "authorized_official_last_name": "SABETI",
        "authorized_official_first_name": "ANIS",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "972-567-4932",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzette M Cooper, PHARMD
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• Jesse George Cops, ATC, LAT
• Carolyn Corbett, N.P.
• Heather Rae Corder, COTA/L
• Erin Cordova
• Ann Cordum, M.D.
• Nic R Cordum, M.D.

• Long Term Care Hospital in Boise, ID
• Providers in Boise, ID by specialty
• Long Term Care Hospital in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.