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General NPI Number Information
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NPI Number | 1730136490
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Entity Type | Organization
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Legal Business Name | TANABELL HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 01/14/2011
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Provider Practice Location Address
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Address Line | 418 FLOYDE ST
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City | MCCALL
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State | ID
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Zip | 83638-4508
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Country | US
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Telephone | 208-634-2112
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Fax | 208-634-3605
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Provider Business Mailing Address
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Address Line | 1009 W QUINN RD
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City | POCATELLO
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State | ID
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Zip | 83202-2425
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Country | US
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Telephone | 208-221-0481
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Fax | 775-307-4049
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Authorized Official
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Title or Position | CEO
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Name | MR. TROY V BELL
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Credential |
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Telephone | 208-221-0481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 16
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License Number State | ID
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