Organization
ADA/CANYON VISITING ANGELS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE VOGEL (OWNER/DIRECTOR)
(208) 888-3611
Entity
Organization
Contact information
Practice address
36 E PINE AVE, MERIDIAN, ID 83642-2329
(208) 888-3611
(208) 621-0245
Mailing address
36 E PINE AVE, MERIDIAN, ID 83642-2329
(208) 888-3611
(208) 621-0245
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808217500
—
ID
05
—
808217501
—
ID
Enumeration date
10/04/2009
Last updated
08/15/2014
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