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General NPI Number Information
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NPI Number | 1255722682
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Entity Type | Organization
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Legal Business Name | RELIANT HEALTHCARE INC
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Dates
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Enumeration Date | 02/06/2015
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Last Update Date | 04/20/2015
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Provider Practice Location Address
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Address Line | 1103 E BEST AVE SUITE E
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City | COEUR D ALENE
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State | ID
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Zip | 83814-4878
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Country | US
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Telephone | 208-665-3514
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Fax | 208-665-3513
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Provider Business Mailing Address
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Address Line | 1103 E BEST AVE SUITE E
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City | COEUR D ALENE
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State | ID
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Zip | 83814-4878
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Country | US
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Telephone | 208-665-3514
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Fax | 208-665-3513
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Authorized Official
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Title or Position | OWNER
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Name | MR. RUDOLPH MICHAEL GALLEGOS
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Credential |
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Telephone | 208-665-3514
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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-262
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License Number State | ID
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