STATE OF IDAHO NPI 1962755868

NPI Information

NPI: 1962755868
Provider Name: STATE OF IDAHO

Doing Business As: SWITC-KYLER HOUSE

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
1182 WEST KYLER AVE
HAYDEN, ID
ZIP 83835
Phone: (208) 762-0244
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STATE OF IDAHO is an intermediate care facility mentally retarded in Hayden, ID. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. STATE OF IDAHO NPI is 1962755868. The provider is registered as an organization entity type.
The provider Is Doing Business As Switc-kyler House.

The provider's business location address is:

1182 WEST KYLER AVE
HAYDEN, ID
ZIP 83835
Phone: (208) 762-0244
Fax: (208) 762-0269

The provider's authorized official is Susan Broetje .
The authorized official title is Administrator and has the following contact phone number (208) 697-0625.

The enumeration date for this NPI number is 10/17/2012 and was last updated on 10/17/2012.

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		81	IDAHO	Yes

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

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