Organization Name: | UT - SIGNATURE HPC LLC |
NPI Number: | 1194112037 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICHARD K NEBEKE (OWNER) |
Mailing Address: | 3544 E 17th St Suite 201 Ammon |
State: | ID US |
Postal Code: | 834066911 |
Phone Number: | 2085240685 |
Fax Number: | 2085240686 |
NPI Enumeration Date: | 04/17/2015 |
NPI Last Update Date: | 04/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |