Organization
MIDNIGHT OIL LTD.
Active
Other names
MDC Magic Valley
Organization subpart
No
Provider details
NPI number
Authorized official
ROB BENNETT (PROGRAM DIRECTOR)
(208) 324-6776
Entity
Organization
Contact information
Practice address
798 LAWRENCE AVE, TWIN FALLS, ID 83301-3635
(208) 324-6776
(208) 324-6636
Mailing address
498 FALLS AVE W, TWIN FALLS, ID 83301-3689
(208) 324-6776
(208) 324-6636
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
5MVDEV037
ID
251J00000X
Nursing Care Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806659900
—
ID
05
—
806667800
—
ID
05
—
806706300
—
ID
05
—
806868800
—
ID
05
—
807035800
—
ID
05
—
807037200
—
ID
05
—
807628200
—
ID
Enumeration date
09/06/2005
Last updated
01/24/2012
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