Healthcare Provider Details

I. General information

NPI: 1699864462
Provider Name (Legal Business Name): PCS HELPING HANDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 E CENTER ST
POCATELLO ID
83201-4702
US

IV. Provider business mailing address

1308 E CENTER ST
POCATELLO ID
83201-4702
US

V. Phone/Fax

Practice location:
  • Phone: 208-232-2009
  • Fax: 208-478-7555
Mailing address:
  • Phone: 208-232-2009
  • Fax: 208-478-7555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHH-199
License Number StateID

VIII. Authorized Official

Name: KARLA JENSEN
Title or Position: ADMINISTRATOR
Credential:
Phone: 208-232-2009