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General NPI Number Information
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NPI Number | 1659368801
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Entity Type | Organization
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Legal Business Name | DISCOVERY CARE CENTRE
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Dates
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Enumeration Date | 10/03/2005
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Last Update Date | 07/18/2007
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Provider Practice Location Address
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Address Line | 600 SHANAFELT ST
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City | SALMON
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State | ID
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Zip | 83467-4261
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Country | US
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Telephone | 208-756-8391
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Fax | 208-756-8398
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Provider Business Mailing Address
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Address Line | 600 SHANAFELT ST
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City | SALMON
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State | ID
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Zip | 83467-4261
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Country | US
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Telephone | 208-756-8391
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Fax | 208-756-8398
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Authorized Official
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Title or Position | BILLER
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Name | MRS. DAWN L BROWN
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Credential |
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Telephone | 208-375-9964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | RC# 594
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | SNF# 90
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License Number State | ID
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