Provider Demographics
NPI:1467440032
Name:HELPING HANDS SANCTUARY OF IDAHO
Entity Type:Organization
Organization Name:HELPING HANDS SANCTUARY OF IDAHO
Other - Org Name:TERRENO GARDENS EXTENDED CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-CHAIRMAN, BOARD OF DIRECTORS
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MCNABB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-251-3681
Mailing Address - Street 1:2043 E. CENTER STREET
Mailing Address - Street 2:SUITE 212
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-3300
Mailing Address - Country:US
Mailing Address - Phone:208-233-4673
Mailing Address - Fax:208-233-4750
Practice Address - Street 1:14966 TERRENO DE FLORES LANE
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2023
Practice Address - Country:US
Practice Address - Phone:408-356-8136
Practice Address - Fax:408-358-3874
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HELPING HANDS SANCTUARY OF IDAHO, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-07
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070000016314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility