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General NPI Number Information
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NPI Number | 1104429141
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Entity Type | Organization
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Legal Business Name | HALO HOME CARE LLC
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Dates
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Enumeration Date | 11/20/2020
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Last Update Date | 11/20/2020
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Provider Practice Location Address
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Address Line | 1111 S ORCHARD ST STE 152
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City | BOISE
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State | ID
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Zip | 83705-1963
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Country | US
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Telephone | 206-643-9484
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 S ORCHARD ST STE 152
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City | BOISE
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State | ID
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Zip | 83705-1963
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Country | US
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Telephone | 206-643-9484
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | FARHIA D MOHAMED
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Credential |
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Telephone | 206-643-9484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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