Shoshone Rehab and Living Center
Organization Active NPI Skilled Nursing Facility · Shoshone, ID
NPI 1750309795 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1750309795
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 20 (ID)
- Legal business name
- SHOSHONE REHAB AND LIVING CENTER
- Practice address
- 511 East 4TH Street
Shoshone, ID 83352 - Phone
- (208) 886-2228
- Fax
- (208) 886-2549
- NPI assigned
- Jul 18, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Sharon Rae Sullivan
- Title
- Business Office Manager
- Phone
- (208) 886-2228
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 20 | ID | Yes |
Addresses
Primary practice location
511 East 4TH Street
Shoshone, ID 83352
Mailing address
511 E 4TH St
Shoshone, ID 83352-5380
Phone (208) 886-2228
Other providers in Shoshone, ID
- Physician Management Services of Idaho, LLC
- Krista Profit
- Christopher Daniel Ritcheson
- Stephanie Roberts
- Janet Sandy
- Shoshone School District No. 312
- Southern Idaho Diabetes Education Program
- Megan Richardson Williams
- Sarah Zohner
All providers in Shoshone, ID · Skilled Nursing Facility in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.