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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