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General NPI Number Information
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NPI Number | 1225254238
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Entity Type | Organization
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Legal Business Name | PERSONAL HOME CARE INC.
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 08/14/2007
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Provider Practice Location Address
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Address Line | 211 ELM
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City | MACKAY
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State | ID
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Zip | 83251
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Country | US
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Telephone | 208-588-2302
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Fax | 208-588-2470
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Provider Business Mailing Address
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Address Line | PO BOX 52
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City | MACKAY
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State | ID
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Zip | 83251-0052
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Country | US
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Telephone | 208-588-2302
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Fax | 208-588-2470
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. CHERI WEBSTER
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Credential | LSW
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Telephone | 208-588-2302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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