Provider Demographics
NPI:1497227649
Name:1 A NORTHWEST SENIOR IN HOME CARE SERVICES INC.
Entity Type:Organization
Organization Name:1 A NORTHWEST SENIOR IN HOME CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:AMADOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-488-4185
Mailing Address - Street 1:2645 N COLE RD STE F
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-5970
Mailing Address - Country:US
Mailing Address - Phone:208-488-4185
Mailing Address - Fax:208-392-1117
Practice Address - Street 1:2645 N COLE RD STE F
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-5970
Practice Address - Country:US
Practice Address - Phone:208-488-4185
Practice Address - Fax:208-392-1117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care