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General NPI Number Information
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NPI Number | 1720602816
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Entity Type | Organization
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Legal Business Name | ANN HOME CARE LLC
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Dates
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Enumeration Date | 06/03/2020
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Last Update Date | 06/17/2020
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Provider Practice Location Address
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Address Line | 42565 SILVER VALLEY RD
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City | KINGSTON
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State | ID
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Zip | 83839-9736
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Country | US
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Telephone | 208-819-8696
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Fax |
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Provider Business Mailing Address
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Address Line | 42565 SILVER VALLEY RD
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City | KINGSTON
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State | ID
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Zip | 83839-9736
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Country | US
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Telephone | 208-819-8696
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | YANHUA GAO
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Credential |
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Telephone | 208-819-8696
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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 |
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License Number State |
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