Provider Demographics
NPI:1801196019
Name:WILLIAMS AND URALDE INC.
Entity Type:Organization
Organization Name:WILLIAMS AND URALDE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-459-3592
Mailing Address - Street 1:6121 CLEVELAND BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83607-5129
Mailing Address - Country:US
Mailing Address - Phone:208-459-3592
Mailing Address - Fax:208-459-2698
Practice Address - Street 1:6121 CLEVELAND BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83607-5129
Practice Address - Country:US
Practice Address - Phone:208-459-3592
Practice Address - Fax:208-459-2698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDRHA-218251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDM0027689Medicaid