1013317064 NPI number — COMPLETE HOSPICE CARE OF BOISE LLC

Table of content: REKHA MENG KHUON LCSW (NPI 1568887263)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013317064 NPI number — COMPLETE HOSPICE CARE OF BOISE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMPLETE HOSPICE CARE OF BOISE LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013317064
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/08/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7558 W THUNDERBIRD RD # 493
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PEORIA
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85381-6080
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
208-391-2724
Provider Business Mailing Address Fax Number:
888-858-4402

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1940 S BONITO WAY STE 140
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MERIDIAN
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83642-2625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-391-2724
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/27/2014

Additional Information

Authorized Official

Authorized Official Last Name:
IGO
Authorized Official First Name:
CHARLOTTE
Authorized Official Middle Name:
Authorized Official Title or Position:
BUSINESS PARTNER
Authorized Official Telephone Number:
208-391-2724

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com