MEDICARE: ARTHUR RETIREMENT COMMUNITY LLC HOME HEALTH

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
1	251E00000X	Home Health Agency	W153086	ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316310865
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARTHUR RETIREMENT COMMUNITY LLC HOME HEALTH

Provider Business Mailing Address
First Line	:	47 E DEPOT ST
Second Line	:
City	:	WESTON
State	:	ID
Zip	:	83286-4908
Country	:	US
Telephone Number	:	208-747-3374
Fax Number	:

Provider Business Practice Location Address
First Line	:	47 E DEPOT ST
Second Line	:
City	:	WESTON
State	:	ID
Zip	:	83286-4908
Country	:	US
Telephone Number	:	208-747-3374
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. RASHEL CUSHMAN
Credential	:
Telephone Number	:	208-747-3374

Provider Enumeration Date	:	11/05/2015
Last Update Date	:	11/05/2015

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