Organization
SWJK77, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN KALINA (OWNER)
(208) 297-5016
Entity
Organization
Contact information
Practice address
126 S COLE RD, BOISE, ID 83709-0932
(208) 297-5016
Mailing address
126 S COLE RD, BOISE, ID 83709-0932
(208) 297-5016
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A0002586
—
ID
Enumeration date
04/20/2016
Last updated
04/20/2016
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