Organization
CASSIA LONG TERM CARE INC DBA PARKE VIEW CARE & REHAB CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICK HOLLOWAY (PRESIDENT)
(208) 375-9964
Entity
Organization
Contact information
Practice address
1475 N COLE RD, BOISE, ID 83704-8537
(208) 375-9964
(208) 375-9958
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
H20
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010013588
REGENCE BLUE SHIELD PROVI
ID
01
—
02758
BLUE CROSS PROVIDER NUMBE
ID
Enumeration date
03/08/2007
Last updated
08/22/2020
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