| NPI | 1598831653 |
|---|---|
| Doing Business As | STATE HOSPITAL NORTH |
| Entity Type | Organization |
| Authorized Contact | TERESA SHACKELFORD Administrative Director 208-476-4511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 283Q00000X Psychiatric Hospital (Licence: ID 24) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2024-06-06 |