Organization
QUALICARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BART O LARSEN LSW (OWNER/MANAGER)
(208) 542-1388
Entity
Organization
Contact information
Practice address
3539 BRIAR CREEK LN, SUITE A, AMMON, ID 83406-4761
(208) 542-1388
(208) 552-7847
Mailing address
3539 BRIAR CREEK LN, SUITE A, AMMON, ID 83406-4761
(208) 542-1388
(208) 552-7847
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
C132647
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8055151
—
ID
05
—
8058569
—
ID
05
—
8068114
—
ID
Enumeration date
12/21/2007
Last updated
02/14/2008
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