Organization
LOST RIVER AREA TRANSIT - AGENCY
Active
Parent organization
VALLEY VISTA CARE CORP
Organization subpart
Yes
Provider details
NPI number
Legal business name
VALLEY VISTA CARE CORP
Authorized official
KASEY BORGMAN (CORP COMPLIANCE)
(208) 245-4576
Entity
Organization
Contact information
Practice address
820 ELM DR, ST MARIES, ID 83861-2119
(208) 245-4576
(208) 245-2138
Mailing address
3668 W. 3700 N., DARLINGTON, ID 83231
(208) 588-3700
(208) 588-2701
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8056283-02
—
ID
Enumeration date
06/28/2010
Last updated
06/28/2010
Update your record
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