Organization
IDAHO FALLS NORTH OF CASCADIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OWEN HAMMOND (PRESIDENT)
(208) 401-9600
Entity
Organization
Contact information
Practice address
840 E ELVA ST, IDAHO FALLS, ID 83401-2801
(208) 401-9600
(208) 314-0639
Mailing address
2205 E RIVERSIDE DR STE 100, EAGLE, ID 83616-7621
(208) 401-9600
(208) 314-0639
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
10/25/2022
Last updated
05/24/2024
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