13D0885724 CLIA NUMBER - COMMUNICARE INC

Laboratory Demographics

CLIA Number: 13D0885724

Facility Name: COMMUNICARE INC

Facility Address:
40 W FRANKLIN RD, STE F
MERIDIAN, ID
ZIP 83642
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Facility Phone Number: 208 888-1155

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver

NPI Number: 1356569362

Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	13D0885724
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	COMMUNICARE INC
Street	40 W FRANKLIN RD, STE F
City	MERIDIAN
State	ID
ZIP	83642
Phone	208 888-1155
CertificateType	4
CertificateEffectiveDate	4/29/2024
CertificateExpirationDate	4/28/2026
FacilityType	Waiver

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