Provider Demographics
NPI:1720086283
Name:HOSPICE VISIONS, INC
Entity Type:Organization
Organization Name:HOSPICE VISIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMALA
Authorized Official - Middle Name:
Authorized Official - Last Name:SLATTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:208-735-0121
Mailing Address - Street 1:455 PARK VIEW LOOP
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-3393
Mailing Address - Country:US
Mailing Address - Phone:208-735-0121
Mailing Address - Fax:208-735-0661
Practice Address - Street 1:1770 PARK VIEW DR
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3252
Practice Address - Country:US
Practice Address - Phone:208-735-0121
Practice Address - Fax:208-735-0661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-08
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1720086283Medicaid