Organization
KELLOG OF CASCADIA, LLC
Active
Other names
Mountain Valley of Cascadia
Organization subpart
No
Provider details
NPI number
Authorized official
OWEN HAMMOND (PRESIDENT)
(208) 401-9600
Entity
Organization
Contact information
Practice address
601 W CAMERON AVE, KELLOGG, ID 83837-2004
(208) 784-1283
Mailing address
408 S EAGLE RD STE 205, EAGLE, ID 83616-6079
(208) 401-9600
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
ID
Other
Enumeration date
08/22/2017
Last updated
05/24/2024
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