IndividualActive
Matthew Henslee, COTA
NPI 1558579979 · Nursing Facility/Intermediate Care Facility · Boise, ID
Provider details
- NPI number
- 1558579979
- Entity type
- Individual
- Primary specialty
- Nursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
- Credential
- COTA
- Sex
- Male
- Sole proprietor
- Yes
- License
- OTA185 (ID)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1130 Allumbaugh St
Boise, ID 83704-8700
Phone: (208) 854-8517
Street-level locationGet directions
Mailing address
340 Stierman Way
Eagle, ID 83616-5166
Registry dates
- Enumerated
- 2007-05-18
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.