Organization
ASPEN MEADOWS HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYNE J HAMBLIN JR. (OWNER)
(208) 940-1350
Entity
Organization
Contact information
Practice address
104 SOUTH WARPATH, SALMON, ID 83467
(208) 940-1350
(208) 756-2903
Mailing address
104 SOUTH WARPATH, SALMON, ID 83467
(208) 940-1350
(208) 756-2903
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A0001540
—
ID
Enumeration date
02/07/2014
Last updated
02/07/2014
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