Organization
VALLEY VISTA CARE CORPORATION
Active
Other names
Valley Vista Care Center of St. Maries
Organization subpart
No
Provider details
NPI number
Authorized official
KASEY D WILKS (DIRECTOR OF CORPORATE COMPLIANCE)
(208) 245-4576
Entity
Organization
Contact information
Practice address
820 ELM ST, ST MARIES, ID 83861-2119
(208) 245-4576
(208) 245-2138
Mailing address
820 ELM ST, ST MARIES, ID 83861-2119
(208) 245-4576
(208) 245-2138
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
23
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002610900
—
ID
Enumeration date
08/01/2006
Last updated
04/09/2025
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