Healthcare Provider Details

I. General information

NPI: 1619605136
Provider Name (Legal Business Name): DIVISION OF VETERANS SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2022
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 PLEASANT VIEW RD. STE: 101
POST FALLS ID
83854
US

IV. Provider business mailing address

590 PLEASANT VIEW RD. STE: 101
POST FALLS ID
83854
US

V. Phone/Fax

Practice location:
  • Phone: 208-415-3430
  • Fax:
Mailing address:
  • Phone: 208-415-3430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: TRACY SCHANER
Title or Position: DEPUTY CHIEF ADMINISTRATOR
Credential:
Phone: 208-780-1320