MATTHEW ALAN HENSLEE

BOISE, ID
NPI1558579979
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy313M00000X Nursing Facility/Intermediate Care Facility
(Licence: ID  ota185)
Enumeration Date2007-05-18
Last Update Date2007-07-08
Business Address
-- MATTHEW ALAN HENSLEE COTA
1130 ALLUMBAUGH ST
BOISE, ID 83704-8700
Phone number: 208-854-8517
Mailing Address
-- MATTHEW ALAN HENSLEE COTA
340 STIERMAN WAY
EAGLE, ID 83616-5166
Phone number: 208-340-4929