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VINES OF LIFE

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Company Details

Name: VINES OF LIFE
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Active-Current
Date of registration: 30 Jan 2006 (19 years ago)
Entity Number: 297312
Place of Formation: IDAHO
File Number: 0000297312
ZIP code: 83713
County: Ada County
Mailing Address: 11088 W EDNA ST BOISE, ID 83713

National Provider Identifier

NPI Number:
1639349004

Authorized Person:

Name:
MRS. JESSICA R VIALPANDO
Role:
ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
310400000X - Assisted Living Facility
Is Primary:
Yes

Contacts:

Fax:
2083222977

Filing

Filing Name Filing Number Filing date
Initial Filing 0000297312 2006-01-30

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Date of last update: 24 Sep 2024

Sources: Idaho Secretary of State