| NPI | 1053435537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA L PARSONS Medicaid Billing Specialist 208-743-1563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 251E00000X Home Health |
| 251J00000X Nursing Care | |
| 251X00000X Supports Brokerage | |
| 253Z00000X In Home Supportive Care | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2025-07-16 |