STATE OF IDAHO
Organization (NPI-2)
Active
Home Health
Provider Information
- NPI Number
1649277393- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 1901 ALVIN RICKEN DR, POCATELLO, ID, 832012727
- Phone
- (208) 239-5210
- Fax
- (208) 478-6306
Specialties & Taxonomies
Home Health
Primary License: ID #13-7001