Organization
SH1 MIDSTATE MGMT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI BAKER (DIRECTOR OF LICENSING)
(564) 203-3620
Entity
Organization
Contact information
Practice address
1367 LOCUST ST N, TWIN FALLS, ID 83301-3477
(208) 735-0700
(208) 735-0900
Mailing address
5101 NE 82ND AVE STE 200, VANCOUVER, WA 98662-6343
(360) 254-9442
(360) 254-1770
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
311500000X
Alzheimer Center (Dementia Center)
—
—
Other
Enumeration date
09/17/2025
Last updated
11/24/2025
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