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General NPI Number Information
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NPI Number | 1003958125
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Entity Type | Organization
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Legal Business Name | NORTHWEST BEC-CORP
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 07/19/2007
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Provider Practice Location Address
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Address Line | 300 2ND AVE E
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City | TWIN FALLS
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State | ID
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Zip | 83301-6425
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Country | US
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Telephone | 208-733-2234
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Fax | 208-733-2542
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Provider Business Mailing Address
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Address Line | PO BOX 5986
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City | TWIN FALLS
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State | ID
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Zip | 83303-5986
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Country | US
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Telephone | 208-733-2234
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Fax | 208-733-2542
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Authorized Official
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Title or Position | OWNER
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Name | DAN ADAMSON
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Credential |
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Telephone | 208-637-0999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HH-222
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License Number State | ID
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