Provider Demographics
NPI:1073090585
Name:STAR VALLEY HEALTHCARE, INC.
Entity Type:Organization
Organization Name:STAR VALLEY HEALTHCARE, INC.
Other - Org Name:SYMBII HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-401-1369
Mailing Address - Street 1:PO BOX 607
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:WY
Mailing Address - Zip Code:83110-0607
Mailing Address - Country:US
Mailing Address - Phone:307-885-7583
Mailing Address - Fax:307-885-7584
Practice Address - Street 1:625 S WASHINGTON ST, STE B
Practice Address - Street 2:
Practice Address - City:AFTON
Practice Address - State:WY
Practice Address - Zip Code:83110
Practice Address - Country:US
Practice Address - Phone:307-885-7583
Practice Address - Fax:307-885-7584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-26
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health