Longshot Enterprises, Inc.

NPI #1396133732 in Pocatello, Idaho

Provider Information

NPI Number
1396133732
Entity Type
Organization
Organization Name
Longshot Enterprises, Inc.
Primary Specialty
Home Health
Enumeration Date
Jan 8, 2015
Last Updated
Jan 21, 2015

Practice Location

Address
353 E LANDER ST
State
Idaho
ZIP Code
83201-6314
Phone
(208) 234-2380

Authorized Official

Name
TERESA NELSON
Title
ADMINISTRATOR
Phone
(208) 234-2380

Specialties & Taxonomy Codes

Specialty
Home Health

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