CLEARWATER CARE CENTER INC. NPI 1972726503

NPI Information

NPI: 1972726503
Provider Name: CLEARWATER CARE CENTER, INC.

Other Name: HILLCREST HOME

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization

CLIA Number: 13D2040624

Address:
1411 FALLS AVE E
SUITE 703
TWIN FALLS, ID
ZIP 83301
Phone: (208) 734-8973
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CLEARWATER CARE CENTER, INC. is an intermediate care facility mentally retarded in Twin Falls, ID. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. CLEARWATER CARE CENTER, INC. NPI is 1972726503. The provider is registered as an organization entity type.
The provider Other Name Is Hillcrest Home.

The provider's business location address is:

1411 FALLS AVE E
SUITE 703
TWIN FALLS, ID
ZIP 83301-455
Phone: (208) 734-8973
Fax: (208) 734-1075

The provider's authorized official is Rene Stephens .
The authorized official title is Administrator and has the following contact phone number (208) 734-8973.

The CLIA number assigned to this NPI record is 13D2040624 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/11/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0026132	MEDICAID	IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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