Provider Demographics
NPI:1770834715
Name:TANABELL HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:TANABELL HEALTH SERVICES, INC
Other - Org Name:COPPER SUMMIT ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:VERLE
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:208-221-0481
Mailing Address - Street 1:1009 W QUINN RD
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83202-2425
Mailing Address - Country:US
Mailing Address - Phone:208-221-0481
Mailing Address - Fax:775-307-4049
Practice Address - Street 1:2424 BIRDIE THOMPSON DRIVE
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201
Practice Address - Country:US
Practice Address - Phone:208-221-0481
Practice Address - Fax:775-307-4049
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TANABELL HEALTH SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-01
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility