Organization
VALLEY VISTA CARE CORPORATION
Active
Organization
VALLEY VISTA CARE CORPORATION
Active
Other names
Countryside Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
GAIL MILLS (CORPORATE COMPLIANCE MANAGER)
(208) 245-4576
Entity
Organization
Contact information
Practice address
4433 BEVERLAND ROAD, MACKAY, ID 83251-0239
(208) 588-2600
(208) 588-3104
Mailing address
820 ELM ST, ST MARIES, ID 83861-2119
(208) 245-4576
(208) 245-2138
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Enumeration date
11/30/2006
Last updated
08/22/2020
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