Provider Demographics
NPI:1255722682
Name:RELIANT HEALTHCARE INC
Entity type:Organization
Organization Name:RELIANT HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RUDOLPH
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GALLEGOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-665-3514
Mailing Address - Street 1:1103 E BEST AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-4878
Mailing Address - Country:US
Mailing Address - Phone:208-665-3514
Mailing Address - Fax:208-665-3513
Practice Address - Street 1:1103 E BEST AVE
Practice Address - Street 2:SUITE E
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-4878
Practice Address - Country:US
Practice Address - Phone:208-665-3514
Practice Address - Fax:208-665-3513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-06
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDHH-262251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health