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General NPI Number Information
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NPI Number | 1174997878
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Entity Type | Organization
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Legal Business Name | ZION'S MANAGEMENT LLC
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Dates
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Enumeration Date | 11/18/2015
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Last Update Date | 11/18/2015
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Provider Practice Location Address
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Address Line | 470 RIGBY LAKE DR.
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City | RIGBY
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State | ID
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Zip | 83442
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Country | US
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Telephone | 208-244-2181
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Fax | 208-902-2565
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Provider Business Mailing Address
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Address Line | 919 S 25TH E
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City | AMMON
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State | ID
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Zip | 83406-5731
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Country | US
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Telephone | 208-244-2181
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Fax | 208-902-2565
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Authorized Official
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Title or Position | OWNER
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Name | MR. KEITH RASMUSSEN
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Credential | OWNER
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Telephone | 208-244-2181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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