Provider Demographics
NPI:1659549525
Name:CAREFIX MANAGEMENT AND CONSULTING, INC.
Entity Type:Organization
Organization Name:CAREFIX MANAGEMENT AND CONSULTING, INC.
Other - Org Name:WILDWOOD ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT- OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-251-2699
Mailing Address - Street 1:3400 STOCKMAN RD
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83204-2070
Mailing Address - Country:US
Mailing Address - Phone:208-221-4721
Mailing Address - Fax:208-637-1193
Practice Address - Street 1:380 1ST AVE E
Practice Address - Street 2:
Practice Address - City:WENDELL
Practice Address - State:ID
Practice Address - Zip Code:83355-5102
Practice Address - Country:US
Practice Address - Phone:208-536-5544
Practice Address - Fax:208-536-2331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDRC919310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility