NPI 1235333576

Idaho Falls Group Homes

Organisation Intellectual Disabilities Intermediate Care Facility Ammon, ID

Practice location

Address: 4360 Wanda St, Ammon, ID 83406-6878
Phone: (208) 522-4614
Mailing address: PO Box 50457, Idaho Falls, ID 83405-0457

Authorised official

Name: Rex Redden
Title: Administrator
Phone: (208) 523-0053

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 29 (ID)

Other Intermediate Care Facility, Intellectual Disabilities providers in Idaho →

Registry record

NPI: 1235333576
Entity type: Organization
NPI issued: 12 Jun 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.