Provider Demographics
NPI:1619605136
Name:DIVISION OF VETERANS SERVICES
Entity Type:Organization
Organization Name:DIVISION OF VETERANS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHANER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-780-1320
Mailing Address - Street 1:590 PLEASANT VIEW RD.
Mailing Address - Street 2:STE: 101
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854
Mailing Address - Country:US
Mailing Address - Phone:208-415-3430
Mailing Address - Fax:
Practice Address - Street 1:590 PLEASANT VIEW RD.
Practice Address - Street 2:STE: 101
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854
Practice Address - Country:US
Practice Address - Phone:208-415-3430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility