MATTHEW ALAN HENSLEE COTA

Nursing/Intermediate Care Facility

Boise, Idaho

Provider NPI: 1558579979

Provider Information:
 MATTHEW ALAN HENSLEE COTA


Practice Location:
1130 ALLUMBAUGH ST  BOISE, ID 83704 US
Tel: 208-854-8517  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	313M00000X	Nursing & Custodial Care Facilities Nursing Facility/Intermediate Care Facility	ID	OTA185