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General NPI Number Information
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NPI Number | 1861687329
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Entity Type | Organization
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Legal Business Name | SEVEN OAKS COMMUNITY HOMES, INC.
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Dates
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Enumeration Date | 09/07/2007
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Last Update Date | 09/07/2007
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Provider Practice Location Address
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Address Line | 583 N LARRI LEE ST
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City | POST FALLS
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State | ID
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Zip | 83854
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Country | US
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Telephone | 208-773-8890
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4243
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City | BOISE
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State | ID
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Zip | 83711-4243
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICHARD DAVIS
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Credential |
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Telephone | 208-376-1861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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