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Organization
PROVIDENCE NURSING SERVICES
Active
Organization
PROVIDENCE NURSING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK G WATKINS JR. RN. (OWNER/MANAGER)
(208) 413-3312
Entity
Organization
Contact information
Practice address
1008 W HONKER DR, MERIDIAN, ID 83642-7735
(208) 413-3312
(208) 209-5123
Mailing address
1008 W HONKER DR, MERIDIAN, ID 83642-7735
(208) 413-3312
(208) 209-5123
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
603069327
ID
Other
Enumeration date
03/22/2011
Last updated
03/22/2011
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