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NPI Code Detail

MEDICARE: HAPPY VALLEY HEALTHCARE LLC

MEDICARE: HAPPY VALLEY HEALTHCARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1114761830
Entity Type Code : Organization
Provider Name (Legal Business Name) : HAPPY VALLEY HEALTHCARE LLC
Provider Business Mailing Address
First Line : 1675 E RIVERSIDE DR STE 150
Second Line :
City : EAGLE
State : ID
Zip : 83616-7584
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1675 E RIVERSIDE DR STE 150
Second Line :
City : EAGLE
State : ID
Zip : 83616-7584
Country : US
Telephone Number : 208-401-1400
Fax Number :
Authorized Official
Title or Position : SECRETARY
Name : AMBER TUELLER
Credential :
Telephone Number : 208-401-1400
Provider Enumeration Date : 06/19/2024
Last Update Date : 06/19/2024

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Directions to “HAPPY VALLEY HEALTHCARE LLC ” Practice Location

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