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General NPI Number Information
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NPI Number | 1487251518
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Entity Type | Organization
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Legal Business Name | IN-HOME CARE OF MCCALL INC
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Dates
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Enumeration Date | 10/01/2020
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 180 HEINRICH LN
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City | MCCALL
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State | ID
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Zip | 83638-5091
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Country | US
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Telephone | 208-315-3208
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4374
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City | MCCALL
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State | ID
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Zip | 83638-8374
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Country | US
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Telephone | 208-315-3208
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RUTH KENNEDY
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Credential | MA
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Telephone | 208-315-3208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #5
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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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