1023433927 NPI number — CIRCLES OF CARING ADULT DAY HEALTH FOUNDATION, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023433927 NPI number — CIRCLES OF CARING ADULT DAY HEALTH FOUNDATION, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CIRCLES OF CARING ADULT DAY HEALTH FOUNDATION, INC.
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:
6
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:
1023433927
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/28/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
225 E PALOUSE RIVER DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOSCOW
Provider Business Mailing Address State Name:
ID
Provider Business Mailing Address Postal Code:
83843-8915
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
208-883-6483
Provider Business Mailing Address Fax Number:
208-883-6489

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
225 E PALOUSE RIVER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOSCOW
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83843-8915
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-883-6483
Provider Business Practice Location Address Fax Number:
208-883-6489
Provider Enumeration Date:
02/28/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MAHONEY
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
ANNE
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
208-883-6483

Provider Taxonomy Codes

  • Taxonomy code: 261QA0600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 188013 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: A0001474 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".