| NPI | 1750309795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON RAE SULLIVAN Business Office Manager 208-886-2228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: ID 20) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-08-22 |