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Ashton Memorial Inc

Organization Active NPI Emotionally Disturbed Childrens' Residential Treatment Facility · Idaho Falls, ID

NPI 1104665587 · NPPES record last updated May 23, 2024

Key facts

NPI
1104665587
Entity type
Organization (NPI type 2)
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X
Legal business name
ASHTON MEMORIAL INC
Practice address
2935 Rollandet St
Idaho Falls, ID 83402-4654
Phone
(208) 542-2905
Fax
(208) 522-2427
NPI assigned
May 23, 2024
Organization subpart
No

Authorized official

Name
Suzanne Brady
Title
HR Director/Compliance Officer
Phone
(208) 652-7461

Corporate family (same tax ID) 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Ashton Memorial Inc (4 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Yes

Addresses

Primary practice location

2935 Rollandet St
Idaho Falls, ID 83402-4654

Mailing address

PO Box 838
Ashton, ID 83420-0838
Phone (208) 652-7461

Other names

  • Gustafson House Doing business as

Other providers in Idaho Falls, ID

All providers in Idaho Falls, ID · Emotionally Disturbed Childrens' Residential Treatment Facility in Idaho

Sources for this page

Verify at the official NPI Registry.