Organization
IDAHO FALLS GROUP HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. REX S REDDEN (ADMINISTRATOR)
(208) 523-0053
Entity
Organization
Contact information
Practice address
275 ASH ST, IDAHO FALLS, ID 83402-4040
(208) 523-0053
(208) 529-3134
Mailing address
PO BOX 50457, IDAHO FALLS, ID 83405
(208) 523-0053
(208) 529-3134
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
71
ID
Other
Enumeration date
01/12/2007
Last updated
08/22/2020
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