Individual provider · Type 1 NPI
Tyson Hanson
Child Intellectual and/or Developmental Disabilities Respite Care · Sheley, ID
NPI number
1457976045
Active
Practice location
1496 N 1070 E
Sheley, ID 83274
Mailing address
315 Wind River Dr
Shelley, ID 83274-2101
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Child Intellectual and/or Developmental Disabilities Respite Care Primary | 385HR2060X | None listed |
Child Intellectual and/or Developmental Disabilities Respite Care: A facility or distinct part of a facility that provides short term, residential care to children diagnosed with intellectual and/or developmental disabilities as respite for the regular caregivers.
About NPI 1457976045
Tyson Hanson's National Provider Identifier is 1457976045, issued on Jun 10, 2020. The primary taxonomy on file is Child Intellectual and/or Developmental Disabilities Respite Care (385HR2060X), and the practice location is in Sheley, ID. The record was last updated on Jun 10, 2020.