Organization · Type 2 NPI
State of Idaho
Intellectual Disabilities Intermediate Care Facility · Hayden, ID
NPI number
1962755868
Active
Practice location
1182 West Kyler Ave
Hayden, ID 83835
Fax (208) 762-0269
Mailing address
1660 11th Ave N
Nampa, ID 83687-5000
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | 81 (ID) |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
About NPI 1962755868
State of Idaho's National Provider Identifier is 1962755868, issued on Oct 17, 2012. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Hayden, ID. The record was last updated on Oct 17, 2012.