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Organization
POCATELLO HEALTH SERVICES, INC.
Active
Organization
POCATELLO HEALTH SERVICES, INC.
Active
Other names
Gateway Transitional Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
SOON BURNAM (TREASURER)
(949) 540-1249
Entity
Organization
Contact information
Practice address
527 MEMORIAL DR, POCATELLO, ID 83201-4063
(208) 478-3333
(208) 478-3331
Mailing address
527 MEMORIAL DR, POCATELLO, ID 83201-4063
(208) 478-3333
(208) 478-3331
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
NULL
Other
Enumeration date
01/31/2018
Last updated
01/31/2018
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