| NPI | 1063613495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA ANN SINCLAIR Cna Office Assistant 208-235-6565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2008-04-17 |