BEAR LAKE MEMORIAL HOSPITAL NPI 1740598614

NPI Information

  • NPI: 1740598614
  • Provider Name: BEAR LAKE MEMORIAL HOSPITAL
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: BEAR LAKE MANOR
  • Address: 855 BOISE ST
    MONTPELIER, ID
    ZIP 83254
  • Phone: (208) 847-2400

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NPI Details

BEAR LAKE MEMORIAL HOSPITAL is an assisted living facility in Montpelier, ID. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. BEAR LAKE MEMORIAL HOSPITAL NPI is 1740598614. The provider is registered as an organization entity type.
The provider Is Doing Business As Bear Lake Manor.

The provider's business location address is:

855 BOISE ST
MONTPELIER, ID
ZIP 83254-070
Phone: (208) 847-2400

The provider's authorized official is Ryan Messerly .
The authorized official title is Pfs Director and has the following contact phone number (208) 847-0920.

The enumeration date for this NPI number is 9/14/2010 and was last updated on 9/14/2010.

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
1310400000XAssisted Living FacilityRC-738IDAHOYes

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
1806513000MEDICAIDIDAHO

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: 11/21/2025

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