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Organization

CLEARWATER HEALTHCARE LLC

Active
Other names
Clearwater Health and Rehabilitation
Organization subpart
No

Provider details

NPI number
Authorized official
KENNETH SHULL (MANAGER)
(208) 476-4568
Entity
Organization

Contact information

Practice address
1204 SHRIVER RD, OROFINO, ID 83544-9033
(208) 476-4568
(208) 476-3614
Mailing address
1204 SHRIVER RD, OROFINO, ID 83544-9033
(208) 476-4568
(208) 476-3614

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
36
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1386681781
ID
Enumeration date
06/02/2006
Last updated
09/08/2016
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