Provider Demographics
NPI:1316104367
Name:ALL VALLEY HOME CARE INC
Entity type:Organization
Organization Name:ALL VALLEY HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAHM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-468-0140
Mailing Address - Street 1:5067 N BUILDING CENTER DR
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-7364
Mailing Address - Country:US
Mailing Address - Phone:208-664-2764
Mailing Address - Fax:208-765-8471
Practice Address - Street 1:321 2ND ST S
Practice Address - Street 2:SUITE 101
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-3764
Practice Address - Country:US
Practice Address - Phone:208-468-0140
Practice Address - Fax:208-466-0580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID807535800251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID807535800Medicaid