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General NPI Number Information
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NPI Number | 1790862563
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Entity Type | Organization
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Legal Business Name | ALTERNATIVES FOR LIFE
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8601 W EMERALD ST STE 100
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City | BOISE
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State | ID
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Zip | 83704-8209
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Country | US
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Telephone | 208-342-1222
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Fax | 208-375-5449
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Provider Business Mailing Address
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Address Line | 9297 N GOVERNMENT WAY STE C
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City | HAYDEN
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State | ID
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Zip | 83835-9290
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Country | US
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Telephone | 208-762-5433
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Fax | 208-209-0007
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Authorized Official
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Title or Position | PRESIDENT
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Name | DONALD D GROSS
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Credential |
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Telephone | 208-762-5433
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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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