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State Of Idaho
Intellectual Disabilities Intermediate Care Facility in Hayden, Idaho
NPI 1962755868

State Of Idaho is a Intellectual Disabilities Intermediate Care Facility based in Nampa, ID. State Of Idaho practices in Hayden, ID. The NPI Number for State Of Idaho is 1962755868 and holds a License No. 81 (Idaho).

The current practice location address for State Of Idaho is 1182 West Kyler Ave, Hayden, ID and can be reached out via phone at 208-762-0244 and via fax at 208-762-0269.

Location: 1182 West Kyler Ave, Hayden, ID, 83687-5000
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1962755868
Provider Name
State Of Idaho
Credential
Provider Entity Type
Organization
Address
1182 West Kyler Ave, Hayden, ID, 83687-5000
Phone Number
208-762-0244
Fax Number
208-762-0269
Provider Enumeration Date
10/17/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1182 West Kyler Ave
City
Hayden
State
Idaho
Zip
83835
Phone Number
208-762-0244
Fax Number
208-762-0269
person
Provider Business Mailing Address Details
Address
1182 West Kyler Ave
City
Hayden
State
Idaho
Zip
83835
Phone Number
208-762-0244
Fax Number
208-762-0269
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
81 (Idaho)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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