Organization
CLEARWATER OPERATIONS, LLC
Active
Other names
Life Care Center of Lewiston
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY S. CROSS (ASSISTANT SECRETARY)
(423) 473-5867
Entity
Organization
Contact information
Practice address
325 WARNER DR, LEWISTON, ID 83501-4437
(208) 798-8500
(208) 798-8530
Mailing address
3001 KEITH ST NW, CLEVELAND, TN 37312-3713
(423) 473-5751
(423) 339-8342
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
85
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8050692
—
ID
05
—
805069200
—
ID
Enumeration date
05/19/2006
Last updated
02/27/2017
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