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MS. VICKI J LARSON

Adult Care Home

Nampa, Idaho

Provider NPI: 1376701367

Provider Information:
MS. VICKI J LARSON 


Practice Location:
2914 E POWERLINE RD  NAMPA, ID 83687 US
Tel: 208-353-0329  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y311ZA0620XNursing & Custodial Care Facilities
Custodial Care Facility
Adult Care Home

Other Provider Identifiers:

IssuerNumberStateType
806519600ID05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




ADULT CARE JOBS ID - Page 1



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