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General NPI Number Information
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NPI Number | 1902274962
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Entity Type | Organization
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Legal Business Name | ELITE HEALTH CARE
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Dates
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Enumeration Date | 09/08/2015
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Last Update Date | 09/08/2015
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Provider Practice Location Address
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Address Line | 919 S 25TH E
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City | AMMON
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State | ID
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Zip | 83406-5731
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Country | US
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Telephone | 208-821-8432
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Fax |
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Provider Business Mailing Address
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Address Line | 919 S 25TH E
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City | AMMON
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State | ID
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Zip | 83406-5731
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Country | US
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Telephone | 208-821-8432
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JENNIFER ANN MURRAY
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Credential |
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Telephone | 208-821-8432
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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 | 253Z00000X
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License Number State | ID
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