13D0705360 CLIA NUMBER - CANYON COUNTY OF CASCADIA DBA WELLSPRING HEALTH & REHABILITATION OF CASCADIA

Laboratory Demographics

CLIA Number: 13D0705360

Facility Name: CANYON COUNTY OF CASCADIA DBA WELLSPRING HEALTH & REHABILITATION OF CASCADIA

Facility Address:
2105 12TH AVENUE RD
NAMPA, ID
ZIP 83686
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Facility Phone Number: 208 467-5721

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1699208280

Taxonomy: 314000000X - Skilled Nursing Facility
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

CLIA Record

Field Name	Field Value
CLIA Number	13D0705360
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	CANYON COUNTY OF CASCADIA DBA WELLSPRING HEALTH & REHABILITATION OF CASCADIA
Street	2105 12TH AVENUE RD
City	NAMPA
State	ID
ZIP	83686
Phone	208 467-5721
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024