Organization
ONESOURCE HHC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD KENNETH NEBEKER (ADMINISTRATOR)
(208) 524-0685
Entity
Organization
Contact information
Practice address
1680 ELK CREEK DR, IDAHO FALLS, ID 83404-1225
(208) 524-0685
(208) 524-0686
Mailing address
1680 ELK CREEK DR, IDAHO FALLS, ID 83404-1225
(208) 524-0685
(208) 524-0686
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04872
BLUE CROSS OF IDAHO
ID
05
—
807698700
—
ID
Enumeration date
07/26/2006
Last updated
11/06/2018
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