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NPI 1356977466

NPI 1356977466 : TANABELL HEALTH SERVICES INC : MERIDIAN, ID

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General NPI Number Information
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    NPI Number           |    1356977466
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    Entity Type          |    Organization 
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    Legal Business Name  |    TANABELL HEALTH SERVICES INC 
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Dates
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    Enumeration Date     |    03/20/2020
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    Last Update Date     |    03/20/2020
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Provider Practice Location Address
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    Address Line         |    2584 E MAGIC VIEW DR 
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    City                 |    MERIDIAN
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    State                |    ID
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    Zip                  |    83646
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    Country              |    US
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    Telephone            |    208-506-5130
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    Fax                  |    208-996-2805
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Provider Business Mailing Address
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    Address Line         |    2584 E MAGIC VIEW DR 
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    City                 |    MERIDIAN
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    State                |    ID
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    Zip                  |    83642
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    Country              |    US
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    Telephone            |    208-506-5130
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    Fax                  |    208-996-2805
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Authorized Official
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    Title or Position    |    PRESIDENT/CEO
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    Name                 |     TROY V BELL 
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    Credential           |    
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    Telephone            |    208-221-0481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    310400000X
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    Taxonomy Name        |    Assisted Living Facility
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    License Number       |    
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    License Number State |    
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