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General NPI Number Information
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NPI Number | 1720398647
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Entity Type | Organization
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Legal Business Name | AT YOUR SERVICE HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 10/13/2010
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Last Update Date | 10/13/2010
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Provider Practice Location Address
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Address Line | 321 2ND ST S STE 103
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City | NAMPA
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State | ID
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Zip | 83651
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Country | US
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Telephone | 208-468-9504
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Fax | 208-468-9496
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Provider Business Mailing Address
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Address Line | 321 2ND ST S STE 103
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City | NAMPA
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State | ID
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Zip | 83651-3767
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Country | US
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Telephone | 208-468-9504
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Fax | 208-468-9496
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MARISOL TREJO
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Credential |
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Telephone | 208-468-9504
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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 |
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License Number State |
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