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General NPI Number Information
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NPI Number | 1700296852
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Entity Type | Organization
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Legal Business Name | AMBITIONS OF IDAHO, INC.
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Dates
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Enumeration Date | 04/29/2014
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Last Update Date | 04/29/2014
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Provider Practice Location Address
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Address Line | 1044 NORTHWEST BLVD. SUITE F
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City | COEUR D'ALENE
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State | ID
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Zip | 83814
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Country | US
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Telephone | 208-676-9395
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Fax | 208-676-9385
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Provider Business Mailing Address
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Address Line | 1044 NORTHWEST BLVD. SUITE F
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City | COEUR D'ALENE
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State | ID
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Zip | 83814
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Country | US
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Telephone | 208-676-9395
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Fax | 208-676-9385
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MR. WILLIAM MORRIS
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Credential |
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Telephone | 208-676-9395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | RHA-228
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License Number State | ID
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