Organization
CREEKSIDE HOSPICE INC.
Active
Organization
CREEKSIDE HOSPICE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT H BREINHOLT (PRESIDENT)
(801) 486-2348
Entity
Organization
Contact information
Practice address
1246 YELLOWSTONE AVE STE C5, POCATELLO, ID 83201-4373
(208) 637-1100
(208) 637-1102
Mailing address
PO BOX 65788, SALT LAKE CITY, UT 84165-0788
(801) 486-2348
(801) 466-8961
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Enumeration date
08/20/2006
Last updated
08/22/2020
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