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Organization

BEAR LAKE MEMORIAL HOSPITAL

Active
Other names
Bear Lake Manor
Organization subpart
No

Provider details

NPI number
Authorized official
RYAN MESSERLY (PFS DIRECTOR)
(208) 847-0920
Entity
Organization

Contact information

Practice address
855 BOISE ST, MONTPELIER, ID 83254-1070
(208) 847-2400
Mailing address
855 BOISE ST, MONTPELIER, ID 83254-1070
(208) 847-2400

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
RC-738
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
806513000
ID
Enumeration date
09/14/2010
Last updated
09/14/2010
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