CLEARWATER CARE CENTER, INC.
Intermediate Care Facility, Mental Illness
Twin Falls, Idaho
Provider NPI: 1063635696
Organization Information:Organization Name: CLEARWATER CARE CENTER, INC.
Practice Location:
1411 FALLS AVE E SUITE 703 TWIN FALLS, ID 83301 US
Tel: 208-734-8973 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:
1411 FALLS AVE E SUITE 703 TWIN FALLS, ID 83301 US
Tel: 208-734-8973 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 310500000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mental Illness | ID |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
8054739 | ID | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin