Organization
NORTHWEST BEC CORP DBA BURLEY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD L. KEDDINGTON NHA (ADMINISTRATOR)
(208) 678-9474
Entity
Organization
Contact information
Practice address
1729 MILLER AVE, BURLEY, ID 83318-2338
(208) 678-9474
(208) 678-3727
Mailing address
PO BOX 1224, BURLEY, ID 83318-0830
(208) 678-9474
(208) 678-3727
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
42
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001989033
—
NV
01
—
01289
314000000X
ID
05
—
1513121
—
LA
05
—
804277200
—
ID
Enumeration date
10/04/2005
Last updated
06/13/2008
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