Organization
ALLIANCE FAMILY SERVICES NORTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEREK J RICHEY (PROGRAM MANAGER)
(208) 265-5049
Entity
Organization
Contact information
Practice address
1101 W MOANA LN, RENO, NV 89509-4775
(208) 265-5049
Mailing address
608 S DIVISION AVE, SANDPOINT, ID 83864-1749
(208) 265-5049
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447574512
MEDICARE NPI FOR IDAHO LOCATION
ID
Enumeration date
06/01/2011
Last updated
06/01/2011
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