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General NPI Number Information
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NPI Number | 1932698586
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Entity Type | Organization
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Legal Business Name | HEALTHY LIVING AT HOME-TWIN FALLS, LLC
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Dates
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Enumeration Date | 05/08/2018
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Last Update Date | 04/03/2020
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Provider Practice Location Address
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Address Line | 2950 E MAGIC VIEW DR STE 150
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City | MERIDIAN
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State | ID
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Zip | 83642-6253
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Country | US
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Telephone | 208-949-7077
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Fax | 208-493-3019
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Provider Business Mailing Address
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Address Line | 2950 E MAGIC VIEW DR STE 150
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City | MERIDIAN
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State | ID
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Zip | 83642-6253
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Country | US
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Telephone | 208-949-7077
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Fax | 208-493-3019
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Authorized Official
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Title or Position | CEO
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Name | JULIO QUINONES
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Credential |
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Telephone | 916-260-5296
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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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