Healthcare Provider Details

I. General information

NPI: 1376903898
Provider Name (Legal Business Name): VALLEY HELP AT HOME SENIOR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2016
Last Update Date: 02/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3965 W 2000 S
REXBURG ID
83440-4012
US

IV. Provider business mailing address

3965 W 2000 S
REXBURG ID
83440-4012
US

V. Phone/Fax

Practice location:
  • Phone: 208-557-4215
  • Fax: 888-384-0874
Mailing address:
  • Phone: 208-557-4215
  • Fax: 888-384-0874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDREW S RAIL
Title or Position: CEO
Credential: MPP
Phone: 208-557-4215