MEDICARE: HELPING HANDS SANCTUARY OF IDAHO, INC.

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	314000000X	Skilled Nursing Facility		CA

General Provider Information

NPI Number	:	1396732319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HELPING HANDS SANCTUARY OF IDAHO, INC.

Provider Business Mailing Address
First Line	:	240 HOSPITAL CIR
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-3953
Country	:	US
Telephone Number	:	714-892-6686
Fax Number	:	714-891-0148

Provider Business Practice Location Address
First Line	:	240 HOSPITAL CIR
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-3953
Country	:	US
Telephone Number	:	714-892-6686
Fax Number	:	714-891-0148

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. ROB R TAKAMI
Credential	:
Telephone Number	:	714-892-6686

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	08/22/2020

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