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General NPI Number Information
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NPI Number | 1396861480
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Entity Type | Organization
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Legal Business Name | DISABILITY ACTION CENTER
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 124 E 3RD ST
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City | MOSCOW
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State | ID
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Zip | 83843-2906
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Country | US
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Telephone | 208-883-0523
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Fax | 208-883-0524
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Provider Business Mailing Address
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Address Line | 307 19TH ST STE A1
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City | LEWISTON
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State | ID
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Zip | 83501-2086
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Country | US
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Telephone | 208-746-9033
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Fax | 208-746-1004
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Authorized Official
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Title or Position | CEO-DIRECTOR
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Name | MARK LEEPER
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Credential |
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Telephone | 208-883-0523
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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 |
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License Number State |
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