Organization
CLEARWATER CARE CENTER, INC.
Active
Other names
Clear Creek Home
Organization subpart
No
Provider details
NPI number
Authorized official
RENE STEPHENS (ADMINISTRATOR)
(208) 734-8973
Entity
Organization
Contact information
Practice address
1411 FALLS AVE E, SUITE 703, TWIN FALLS, ID 83301-3455
(208) 734-8973
(208) 734-1075
Mailing address
1411 FALLS AVE E, SUITE 703, TWIN FALLS, ID 83301-3455
(208) 734-8973
(208) 734-1075
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8067840
—
ID
Enumeration date
04/11/2007
Last updated
08/22/2020
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