State of Idaho Department of Health and Welfare

NPI #1518022342 in Blackfoot, Idaho

Provider Information

NPI Number
1518022342
Entity Type
Organization
Organization Name
State of Idaho Department of Health and Welfare
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Dec 22, 2006
Last Updated
Feb 8, 2012

Practice Location

Address
700 E ALICE ST
Address 2
BOX 400
State
Idaho
ZIP Code
83221-4925
Phone
(208) 785-1200

Authorized Official

Name
MRS. TRACEY G. SESSIONS
Title
ADMINISTRATIVE DIRECTOR
Phone
(208) 785-8402

Specialties & Taxonomy Codes

Specialty
Skilled Nursing Facility

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