Organization
BOUNDARY COUNTY COMMUNITY RESTORIUM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARLENE MAGEE (ADMINISTRATOR)
(208) 267-2453
Entity
Organization
Contact information
Practice address
6619 KANIKSU ST, BONNERS FERRY, ID 83805-7532
(208) 267-2453
(208) 267-7823
Mailing address
6619 KANIKSU ST, BONNERS FERRY, ID 83805-7532
(208) 267-2453
(208) 267-7823
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
RC-118
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A0000437
—
ID
Enumeration date
02/19/2016
Last updated
02/19/2016
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