Division Of Veterans Services
Skilled Nursing Facility in Lewiston, ID. Organization (NPI-2).
NPI number1679562011
StatusActive
Last updated in NPPESOct 30, 2024
Details
- NPI
- 1679562011
- Entity type
- Organization (NPI-2)
- Legal business name
- Division Of Veterans Services
- Organization subpart
- No
- Enumeration date
- Oct 18, 2005
- Certification date
- Oct 30, 2024
- Last updated
- Oct 30, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | 91 | ID | Yes |
Other names
- Idaho State Veterans Home - Lewiston (Other Name)
Practice location
821 21st AveLewiston, ID 83501-6389
Phone 208-799-3422 · Fax 208-799-3414
Mailing address
821 21st AveLewiston, ID 83501-6389
Phone 208-799-3422 · Fax 208-799-3414
Authorized official
Tracy Schaner
Deputy Chief Administrator
2087801320
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