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Organization
CLEARWATER CARE CENTER, INC.
Active
Organization
CLEARWATER CARE CENTER, INC.
Active
Other names
Blake View Home
Organization subpart
No
Provider details
NPI number
Authorized official
RENE STEPHENS (ADMINISTRATOR)
(208) 734-8973
Entity
Organization
Contact information
Practice address
1411 FALLS AVE E STE 703, TWIN FALLS, ID 83301-3455
(208) 734-8973
(208) 734-1075
Mailing address
1411 FALLS AVE E STE 703, TWIN FALLS, ID 83301-3455
(208) 734-8973
(208) 734-1075
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NPI
—
ID
Enumeration date
08/25/2017
Last updated
07/21/2022
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