institution
State Of Idaho
Community Based Hospice Care Agency in Pocatello, Idaho
NPI 1902995814

State Of Idaho is a Community Based Hospice Care Agency based in Pocatello, ID. State Of Idaho practices in Pocatello, ID. The NPI Number for State Of Idaho is 1902995814 and holds a License No. 13-1512 (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 208-239-5240 and via fax at 208-478-6306.

Location: 1901 Alvin Ricken Dr, Pocatello, ID, 83201-2727
institution
Provider Profile Details
NPI Number
1902995814
Provider Name
State Of Idaho
Credential
Provider Entity Type
Organization
Address
1901 Alvin Ricken Dr, Pocatello, ID, 83201-2727
Phone Number
208-239-5240
Fax Number
208-478-6306
Provider Enumeration Date
10/11/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1901 Alvin Ricken Dr
City
State
Zip
83201-2727
Phone Number
208-239-5240
Fax Number
208-478-6306
person
Provider Business Mailing Address Details
Address
1901 Alvin Ricken Dr
City
State
Zip
83201-2727
Phone Number
208-239-5240
Fax Number
208-478-6306
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Hospice Care, Community Based
Speciality
-
Taxonomy
License No.
13-1512 (Idaho)
Definition
Definition to come...
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