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PREFERRED COMMUNITY HOMES, LLC

Intermediate Care Mentally Retarded

Meridian, Idaho

Provider NPI: 1104960707

Organization Information:
Organization Name:  PREFERRED COMMUNITY HOMES, LLC
Authorized Official:  JASON  MCARTHUR  CFO  503-3625235

Practice Location:
699 S OTTER AVE  MERIDIAN, ID 83642 US
Tel: 208-288-2399  Fax: --

Business Mailing Address:
3155 RIVER RD S STE 100  SALEM, OR 97302 US
Tel: 503-362-5235  Fax: 503-585-3267

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
ID

Other Provider Identifiers:

IssuerNumberStateType
LT032IDAK05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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