Organization
DIVISION OF VETERANS SERVICES
Active
Other names
Idaho State Veterans Home - Boise
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY SCHANER (DEPUTY CHIEF ADMINISTRATOR)
(208) 780-1320
Entity
Organization
Contact information
Practice address
320 COLLINS RD, BOISE, ID 83702-4519
(208) 780-1600
(208) 780-1601
Mailing address
320 COLLINS RD, BOISE, ID 83702-4519
(208) 334-5000
(208) 334-4753
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
93
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1307176
NCPDP
ID
01
—
135131
MEDICARE/OSCAR
ID
01
—
1639HP
PHARMACY LICENSE
ID
05
—
8058337
—
ID
01
—
93
NURSING FACILITY LICENSE
ID
Enumeration date
10/26/2005
Last updated
10/30/2024
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