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NPI Code Detail

MEDICARE: UPPER VALLEY RESOURCE & COUNSELING CENTER

MEDICARE: UPPER VALLEY RESOURCE & COUNSELING CENTER
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
1251B00000XCase Management Agency

Other Identifiers

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

General Provider Information

NPI Number : 1487093845
Entity Type Code : Organization
Provider Name (Legal Business Name) : UPPER VALLEY RESOURCE & COUNSELING CENTER
Provider Business Mailing Address
First Line : 1223 S RAILROAD AVE
Second Line :
City : SUGAR CITY
State : ID
Zip : 83448-5072
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1223 S RAILROAD AVE
Second Line :
City : SUGAR CITY
State : ID
Zip : 83448-5072
Country : US
Telephone Number : 208-359-0519
Fax Number :
Authorized Official
Title or Position : BUSINESS MANAGER
Name : DANIEL K HYMAS
Credential :
Telephone Number : 208-359-0519
Provider Enumeration Date : 06/19/2013
Last Update Date : 06/19/2013

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Directions to “UPPER VALLEY RESOURCE & COUNSELING CENTER ” Practice Location

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