Provider Demographics
NPI:1710551601
Name:PRESTON-WOOD AND ASSOCIATES, LLC
Entity Type:Organization
Organization Name:PRESTON-WOOD AND ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MATT
Authorized Official - Last Name:PRESTON
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:208-888-9962
Mailing Address - Street 1:9492 W FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8101
Mailing Address - Country:US
Mailing Address - Phone:208-888-9962
Mailing Address - Fax:208-888-2186
Practice Address - Street 1:9492 W FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8101
Practice Address - Country:US
Practice Address - Phone:208-888-9962
Practice Address - Fax:208-888-2186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care