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General NPI Number Information
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NPI Number | 1427356724
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Entity Type | Organization
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Legal Business Name | SOUTHERN IDAHO HOME HEALTH & STAFFING
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Dates
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Enumeration Date | 03/10/2011
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Last Update Date | 03/10/2011
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Provider Practice Location Address
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Address Line | 131 MAIN AVE E STE 1
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City | TWIN FALLS
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State | ID
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Zip | 83301-6229
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Country | US
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Telephone | 208-733-8000
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Fax | 208-944-3398
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Provider Business Mailing Address
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Address Line | 131 MAIN AVE E STE 1
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City | TWIN FALLS
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State | ID
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Zip | 83301-6229
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Country | US
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Telephone | 208-733-8000
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Fax | 208-944-3398
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. HOWARD WAYNE BOSH
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Credential |
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Telephone | 208-733-8000
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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 | HH252
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License Number State | ID
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