# BEAR LAKE COUNTY MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BEAR LAKE COUNTY MEMORIAL HOSPITAL
- **Other names:** Bear Lake County Memorial Home Health
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1669521084
- **Legal business name:** BEAR LAKE COUNTY MEMORIAL HOSPITAL
- **Authorized official:** MRS. SHAUNA DAWES (DIRECTOR OF HOME HEALTH)
- **Authorized official phone:** (208) 847-4454

## Contact information

- **Practice address:** 164 S 5TH ST, MONTPELIER, ID 83254-1557
- **Practice address phone:** (208) 847-4454
- **Practice address fax:** (208) 847-4414
- **Mailing address:** 164 S 5TH ST, MONTPELIER, ID 83254-1557
- **Mailing address phone:** (208) 847-4454
- **Mailing address fax:** (208) 847-4414

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | HH107 | ID | Yes |

## Other

- **Enumeration date:** 01/09/2007
- **Last updated:** 07/14/2015