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Organization

ST. LUKE'S CANYON VIEW

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM FULLMER RN, MA (DIRECTOR)
(208) 814-7906
Entity
Organization

Contact information

Practice address
228 SHOUP AVE W, TWIN FALLS, ID 83301-5022
(208) 814-7900
Mailing address
228 SHOUP AVE W, TWIN FALLS, ID 83301-5022
(208) 814-7900

Taxonomy

Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
33030
ID

Other

Enumeration date
06/30/2015
Last updated
06/30/2015
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