Organization · NPI-2
East Idaho Residential Habilitation LLC
Residential Treatment Facility, Intellectual and/or Developmental Disabilities · Idaho Falls, ID
NPI number1376340893
StatusActive
Last updated in NPPESMar 3, 2025
Details
- NPI
- 1376340893
- Entity type
- Organization (NPI-2)
- Legal business name
- East Idaho Residential Habilitation LLC
- Organization subpart
- No
- Enumeration date
- Mar 3, 2025
- Certification date
- Mar 2, 2025
- Last updated
- Mar 3, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – | Yes |
Practice location
550 Linden DrIdaho Falls, ID 83401-4149
Phone 208-360-8102
Mailing address
550 Linden DrIdaho Falls, ID 83401-4149
Phone 208-360-8102
Other practice locations
1061 Curlew Dr
Ammon, ID 83406-4766
Ammon, ID 83406-4766
Phone 208-821-6360
1098 Diamond Dr
Ammon, ID 83406-4928
Ammon, ID 83406-4928
Phone 208-821-6360
Authorized official
Karen Faye Tornkvist
Owner
2083608102
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