Living Waters LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

LIVING WATERS LLC

Practice address

855 S Curtis Rd
Boise, ID 83705-1810

Phone

(208) 378-9911

Fax

(208) 378-9911

NPI assigned

Jul 9, 2025

Last updated

Jul 9, 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

Amanda Dehaas

Title

Owner

Phone

(208) 378-9911

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1752019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752019200000",
    "number": "1750271748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 S CURTIS RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051810",
            "telephone_number": "208-378-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 S CURTIS RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051810",
            "telephone_number": "208-378-9911",
            "fax_number": "208-378-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WATERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-09",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A",
        "authorized_official_last_name": "DEHAAS",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-378-9911"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Boise, ID
• Providers in Boise, ID by specialty
• Health Service Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.