Organization
POCATELLO HEALTH SERVICES, INC.
Active
Other names
Gateway Transitional Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
SOON BURNAM (TREASURER)
(949) 540-1249
Entity
Organization
Contact information
Practice address
527 MEMORIAL DR, POCATELLO, ID 83201-4063
(208) 478-3333
(208) 478-3331
Mailing address
527 MEMORIAL DR, POCATELLO, ID 83201-4063
(208) 478-3333
(208) 478-3331
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
01/31/2018
Last updated
01/31/2018
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