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State Of Idaho
Home Health Agency in Pocatello, Idaho
NPI 1649277393

State Of Idaho is a Home Health Agency based in Pocatello, ID. State Of Idaho practices in Pocatello, ID. The NPI Number for State Of Idaho is 1649277393 and holds a License No. 13-7001 (Idaho).

The current practice location address for State Of Idaho is 1901 Alvin Ricken Dr, Pocatello, ID and can be reached out via phone at 208-239-5210 and via fax at 208-478-6306.

Location: 1901 Alvin Ricken Dr, Pocatello, ID, 83201-2727
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1649277393
Provider Name
State Of Idaho
Credential
Provider Entity Type
Organization
Address
1901 Alvin Ricken Dr, Pocatello, ID, 83201-2727
Phone Number
208-239-5210
Fax Number
208-478-6306
Provider Enumeration Date
07/07/2005
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1901 Alvin Ricken Dr
City
Pocatello
State
Idaho
Zip
83201-2727
Phone Number
208-239-5210
Fax Number
208-478-6306
person
Provider Business Mailing Address Details
Address
1901 Alvin Ricken Dr
City
Pocatello
State
Idaho
Zip
83201-2727
Phone Number
208-239-5210
Fax Number
208-478-6306
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Home Health
Speciality
-
Taxonomy
251E00000X
License No.
13-7001 (Idaho)
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
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