Organization
ALLEGIANT HEALTH LLC
Active
Other names
Allegiant Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE SMITH (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
253Z00000X
In Home Supportive Care Agency
Primary
1740674621
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740674621
—
ID
01
—
8Q516 1740674621
BLUE CROSS
ID
Enumeration date
04/10/2017
Last updated
04/10/2017
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