Organization
EMMETT REHABILITATION & HEALTH CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. A KEITH HOLLOWAY (PRESIDENT)
(208) 375-9964
Entity
Organization
Contact information
Practice address
714 N BUTTE AVE, EMMETT, ID 83617-2725
(208) 365-4425
Mailing address
1475 N COLE RD, BOISE, ID 83704-8537
(208) 375-9964
(208) 375-9958
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
19
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083800759
MEDICARE NPI
ID
Enumeration date
10/23/2007
Last updated
10/29/2007
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