Provider Demographics
NPI:1659089514
Name:SE ID CAREGIVING LLC
Entity Type:Organization
Organization Name:SE ID CAREGIVING LLC
Other - Org Name:HAPPY TO HELP CAREGIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONTANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-240-8559
Mailing Address - Street 1:372 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83204-4806
Mailing Address - Country:US
Mailing Address - Phone:208-417-7627
Mailing Address - Fax:
Practice Address - Street 1:372 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83204-4806
Practice Address - Country:US
Practice Address - Phone:208-417-7627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-09
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty