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General NPI Number Information
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NPI Number | 1811291602
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Entity Type | Organization
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Legal Business Name | PAYETTE SENIOR CENTER
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Dates
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Enumeration Date | 01/07/2011
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Last Update Date | 01/07/2011
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Provider Practice Location Address
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Address Line | 137 N MAIN ST
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City | PAYETTE
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State | ID
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Zip | 83661-2521
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Country | US
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Telephone | 208-642-4223
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Fax |
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Provider Business Mailing Address
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Address Line | 137 N MAIN ST
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City | PAYETTE
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State | ID
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Zip | 83661-2521
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Country | US
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Telephone | 208-642-4223
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Fax |
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Authorized Official
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Title or Position | ASST. HEAD OF BOARD
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Name | MARGARET TRENT
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Credential |
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Telephone | 208-642-4223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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