Individual provider · Type 1 NPI
Cole Shane Odom
Intellectual and/or Developmental Disabilities Residential Treatment Facility · Nampa, ID
Practice location
3420 S. Fork Ave
Nampa, ID 83686
Mailing address
3420 S Fork Ave
Nampa, ID 83686-4856
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Private Vehicle | 347C00000X | None listed |
| Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary | 320600000X | None listed |
Intellectual and/or Developmental Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
Other intellectual and/or developmental disabilities residential treatment facility providers in Nampa
About NPI 1821971326
Cole Shane Odom's National Provider Identifier is 1821971326, issued on Jul 30, 2025. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Nampa, ID. The record was last updated on Jul 30, 2025.