Individual
UTE HATHAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1421 W POLELINE AVE, POST FALLS, ID 83854-9828
(208) 457-2887
Mailing address
1421 W POLELINE AVE, POST FALLS, ID 83854-9828
(208) 457-2887
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
A0000717
ID
Other
Enumeration date
06/03/2019
Last updated
06/03/2019
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