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General NPI Number Information
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NPI Number | 1508659848
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Entity Type | Organization
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Legal Business Name | EIYH ICF LLC
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 1061 CURLEW DR
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City | AMMON
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State | ID
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Zip | 83406-4766
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Country | US
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Telephone | 208-360-8102
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Fax | 208-656-7357
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Provider Business Mailing Address
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Address Line | 550 LINDEN DR
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City | IDAHO FALLS
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State | ID
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Zip | 83401-4149
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Country | US
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Telephone | 208-360-8102
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Fax | 208-656-7357
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Authorized Official
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Title or Position | MANAGER
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Name | KAREN TORNKVIST
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Credential |
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Telephone | 208-360-8102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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