# HEALTHY LIVING AT HOME-POCATELLO, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104315753
- **Authorized official:** SARAH RUSHTON (REGIONAL VICE PRESIDENT)
- **Authorized official phone:** (208) 999-4110

## Contact information

- **Practice address:** 2950 E MAGIC VIEW DR STE 150, MERIDIAN, ID 83642-6253
- **Practice address phone:** (208) 949-7077
- **Mailing address:** 2950 E MAGIC VIEW DR STE 150, MERIDIAN, ID 83642-6253
- **Mailing address phone:** (208) 949-7077

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 05/08/2018
- **Last updated:** 05/08/2018