Organization
ALLEGIANT HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACY LOUISE BERRY (EXECUTIVE DIRECTOR)
(208) 466-0987
Entity
Organization
Contact information
Practice address
210 12TH AVE RD, NAMPA, ID 83686-5013
(208) 466-0987
(208) 466-0985
Mailing address
210 12TH AVE RD, NAMPA, ID 83686-5013
(208) 466-0987
(208) 466-0985
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1740674621
ID
Other
Enumeration date
05/18/2018
Last updated
05/18/2018
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