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General NPI Number Information
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NPI Number | 1295853331
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Entity Type | Organization
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Legal Business Name | WDB, INC.
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 141 SHOSHONE ST N
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City | TWIN FALLS
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State | ID
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Zip | 83301-6150
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Country | US
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Telephone | 208-734-4344
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Fax | 208-736-8582
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Provider Business Mailing Address
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Address Line | 141 SHOSHONE ST N
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City | TWIN FALLS
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State | ID
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Zip | 83301-6150
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Country | US
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Telephone | 208-734-4344
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Fax | 208-736-8582
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Authorized Official
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Title or Position | ASSISTANT BOOKKEEPER
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Name | TESS LYNNE ALLEN
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Credential |
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Telephone | 208-734-4344
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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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