Healthcare Provider Details

I. General information

NPI: 1790845154
Provider Name (Legal Business Name): A&R CASE MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 01/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 HOLLY ST
NAMPA ID
83686-5104
US

IV. Provider business mailing address

210 HOLLY ST
NAMPA ID
83686-5104
US

V. Phone/Fax

Practice location:
  • Phone: 208-463-9313
  • Fax: 208-442-0857
Mailing address:
  • Phone: 208-463-9313
  • Fax: 208-442-0857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number3A&RCASE085
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: JOANNE ANDERSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 208-463-9313