Provider Demographics
NPI:1194593723
Name:A MAGIC VALLEY CAREGIVING LLC
Entity type:Organization
Organization Name:A MAGIC VALLEY CAREGIVING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:T
Authorized Official - Last Name:POWELL-REES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-240-6058
Mailing Address - Street 1:450 FALLS AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-2307
Mailing Address - Country:US
Mailing Address - Phone:208-240-6058
Mailing Address - Fax:208-561-6076
Practice Address - Street 1:450 FALLS AVE STE 106
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-2307
Practice Address - Country:US
Practice Address - Phone:208-595-5045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-13
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care