NPI 1073226437

Gary Robert Martin

Practitioner Foster Care Agency Naples, ID

Practice location

Address: 516 Laurel Lane, Naples, ID 83847
Phone: (208) 610-1686
Mailing address: 516 Laural Ln, Naples, ID 83847-5190

Registered specialties (3)

Foster Care Agency Primary

Agencies Taxonomy 253J00000X Licence CHF-2918 (ID)

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In Home Supportive Care Agency

Agencies Taxonomy 253Z00000X

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Assisted Living Facility

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence CHF-2918 (ID)

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Registry record

NPI: 1073226437
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Dec 2022
Record last updated: 16 Feb 2023

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.