LOST RIVERS DISTRICT HOSPITAL
Assisted Living Facility
Arco, Idaho
Provider NPI: 1689672495
Organization Information:Organization Name: LOST RIVERS DISTRICT HOSPITAL
Practice Location:
551 HIGHLAND DR ARCO, ID 83213 US
Tel: 208-527-8206 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
551 HIGHLAND DR ARCO, ID 83213 US
Tel: 208-527-8206 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility | ID | H45 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
002301800 | ID | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin