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General NPI Number Information
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NPI Number | 1538283205
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Entity Type | Organization
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Legal Business Name | MULTICARE HOME HEALTH INC.
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 324 S MERIDIAN RD SUITE 10
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City | MERIDIAN
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State | ID
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Zip | 83642-2959
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Country | US
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Telephone | 208-884-5497
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Fax | 208-887-7727
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Provider Business Mailing Address
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Address Line | PO BOX 355
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City | MERIDIAN
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State | ID
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Zip | 83680-0355
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Country | US
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Telephone | 208-884-5497
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Fax | 208-887-7727
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. MIMI WALLIS
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Credential |
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Telephone | 208-884-5497
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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 | HH-212
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License Number State | ID
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