# POCATELLO HEALTH SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gateway Transitional Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386142727
- **Authorized official:** SOON BURNAM (TREASURER)
- **Authorized official phone:** (949) 540-1249

## Contact information

- **Practice address:** 527 MEMORIAL DR, POCATELLO, ID 83201-4063
- **Practice address phone:** (208) 478-3333
- **Practice address fax:** (208) 478-3331
- **Mailing address:** 527 MEMORIAL DR, POCATELLO, ID 83201-4063
- **Mailing address phone:** (208) 478-3333
- **Mailing address fax:** (208) 478-3331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0401X | Comprehensive Outpatient Rehabilitation Facility (CORF) | — | NULL | Yes |

## Other

- **Enumeration date:** 01/31/2018
- **Last updated:** 01/31/2018