Organization
CHAROLAIS CARE II, INC
Active
Other names
Valley South Hospital for Geriatric Psychiatry
Organization subpart
No
Provider details
NPI number
Authorized official
CARLEEN WELLARD (ADMINISTRATIVE ASSISTANT)
(208) 221-2019
Entity
Organization
Contact information
Practice address
500 POLK ST E, KIMBERLY, ID 83341-1618
(208) 423-5591
Mailing address
110 N 800 E, JEROME, ID 83338-5724
(208) 904-4030
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Enumeration date
10/15/2008
Last updated
10/15/2008
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