MEDICARE: HELPING HANDS SANCTUARY OF IDAHO, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174603328
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HELPING HANDS SANCTUARY OF IDAHO, INC.

Provider Business Mailing Address
First Line	:	PO BOX 4837
Second Line	:
City	:	POCATELLO
State	:	ID
Zip	:	83205-4837
Country	:	US
Telephone Number	:	208-637-0999
Fax Number	:	208-637-1195

Provider Business Practice Location Address
First Line	:	3880 VIA LUCERO
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93110-1605
Country	:	US
Telephone Number	:	805-687-6651
Fax Number	:	805-682-5208

Authorized Official
Title or Position	:	AR SPECIALIST
Name	:	MISS REBECCA LOUISE ADAMSON
Credential	:
Telephone Number	:	208-221-6828

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	08/22/2020

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