Healthcare Provider Details

I. General information

NPI: 1346574712
Provider Name (Legal Business Name): SILVER VALLEY HOME HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2009
Last Update Date: 10/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 MARKWELL
SILVERTON ID
83867
US

IV. Provider business mailing address

PO BOX 866
KELLOGG ID
83837-0866
US

V. Phone/Fax

Practice location:
  • Phone: 208-556-0959
  • Fax:
Mailing address:
  • Phone: 208-556-0959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL HULL
Title or Position: PRESIDENT
Credential: R.N.
Phone: 208-556-0959