Provider Demographics
NPI:1952646689
Name:TREASURE VALLEY HOME CARE LLC
Entity Type:Organization
Organization Name:TREASURE VALLEY HOME CARE LLC
Other - Org Name:HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BRITTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-888-9962
Mailing Address - Street 1:55 W WILLOWBROOK DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-3242
Mailing Address - Country:US
Mailing Address - Phone:208-888-9962
Mailing Address - Fax:208-888-2186
Practice Address - Street 1:55 W WILLOWBROOK DR
Practice Address - Street 2:SUITE 101
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-3242
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:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDM8085186Medicaid