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General NPI Number Information
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NPI Number | 1346077872
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Entity Type | Organization
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Legal Business Name | NEIGHBORWORKS POCATELLO
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Dates
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Enumeration Date | 09/18/2024
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 629 N HARRISON AVE
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City | POCATELLO
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State | ID
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Zip | 83204-2935
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Country | US
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Telephone | 208-251-2811
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Fax |
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Provider Business Mailing Address
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Address Line | 206 N ARTHUR AVE
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City | POCATELLO
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State | ID
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Zip | 83204-3104
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Country | US
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Telephone | 208-232-9468
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Fax | 208-232-9231
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Authorized Official
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Title or Position | PROPERTY MANAGER208
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Name | DAVID L STAHLECKER
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Credential |
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Telephone | 208-232-9468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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