Organization
WESTERN VISITING NURSES, INC.
Active
Other names
Western Choice Home Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEXTRAL DALE MILES MBA (ADMINISTRATOR)
(208) 522-3291
Entity
Organization
Contact information
Practice address
1400 BENTON ST, IDAHO FALLS, ID 83401-4253
(208) 522-3291
(208) 529-3914
Mailing address
1400 BENTON ST, IDAHO FALLS, ID 83401-4253
(208) 522-3291
(208) 529-3914
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HH-195
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002538000
—
ID
05
—
002568200
—
ID
Enumeration date
07/07/2005
Last updated
03/06/2012
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