Organization Name: | SOLACE HEALTHCARE |
NPI Number: | 1417260563 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JUSTIN CHENEY (CHIEF ADMINISTRATIVE OFFICE) |
Mailing Address: | 197 Stockham Blvd Suite 2b Rigby |
State: | ID US |
Postal Code: | 834421275 |
Phone Number: | 2087578444 |
Fax Number: | 2089658351 |
NPI Enumeration Date: | 07/19/2010 |
NPI Last Update Date: | 03/12/2012 |
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: |