Organization
IDAHO FALLS RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARYL R SHURTLIFE (ASSIST. ADMINISTRATOR)
(208) 529-5285
Entity
Organization
Contact information
Practice address
1957 E 17TH STREET, IDAHO FALLS, ID 83404
(208) 529-5285
(208) 529-5287
Mailing address
1957 E 17TH STREET, IDAHO FALLS, ID 83404
(208) 529-5285
(208) 529-5287
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
56
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00638
BLUE CROSS
ID
Enumeration date
09/21/2006
Last updated
08/22/2020
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