Organization
LACROSSE HEALTH- COEUR D'ALENE, LLC
Active
Other names
LaCrosse Health & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOV E. JACOBS (MANAGER)
(323) 678-4426
Entity
Organization
Contact information
Practice address
210 W LACROSSE AVE, COEUR D ALENE, ID 83814-2403
(208) 664-2185
(208) 664-1604
Mailing address
210 WEST LACROSSE AVENUE, COEUR D'ALENE, ID 83814-2403
(208) 664-2185
(208) 664-1604
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000283700
—
ID
Enumeration date
11/24/2006
Last updated
08/17/2017
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