| NPI | 1306977889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK HOLLOWAY Administrator 208-375-9964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: ID 28) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |