| Idaho Vacation Rentals Llc | |
|
227 W 19th St Idaho Falls ID 83402-4438 | |
| (208) 360-9992 | |
| Not Available |
| Full Name | Idaho Vacation Rentals Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 227 W 19th St, Idaho Falls, Idaho |
| Authorized Official Name and Position | Daren Clint Long (PROGRAM MANAGER) |
| Authorized Official Contact | 2083609992 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Vacation Rentals Llc 673 10th St Idaho Falls ID 83404-5002 Ph: (208) 360-9992 | Idaho Vacation Rentals Llc 227 W 19th St Idaho Falls ID 83402-4438 Ph: (208) 360-9992 |
| NPI Number | 1689409500 |
|---|---|
| Provider Enumeration Date | 09/03/2024 |
| Last Update Date | 09/03/2024 |
| Certification Date | 09/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689409500 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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