Provider Demographics
NPI:1740046945
Name:STAY CARE LIFE SERVICES
Entity type:Organization
Organization Name:STAY CARE LIFE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALENE
Authorized Official - Middle Name:
Authorized Official - Last Name:EGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-807-3384
Mailing Address - Street 1:29 BOULDER LN
Mailing Address - Street 2:
Mailing Address - City:HORSESHOE BEND
Mailing Address - State:ID
Mailing Address - Zip Code:83629-9001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:29 BOULDER LN
Practice Address - Street 2:
Practice Address - City:HORSESHOE BEND
Practice Address - State:ID
Practice Address - Zip Code:83629-9001
Practice Address - Country:US
Practice Address - Phone:208-807-3384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care