Provider Demographics
NPI:1649692609
Name:TANABELL HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:TANABELL HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:V
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, NHA
Authorized Official - Phone:208-221-0481
Mailing Address - Street 1:4881 CLOVER DELL RD
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83202-1805
Mailing Address - Country:US
Mailing Address - Phone:208-252-5902
Mailing Address - Fax:775-307-4049
Practice Address - Street 1:410 W 1ST N
Practice Address - Street 2:
Practice Address - City:REXBURG
Practice Address - State:ID
Practice Address - Zip Code:83440
Practice Address - Country:US
Practice Address - Phone:208-359-7676
Practice Address - Fax:208-359-7677
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TANABELL HEALTH SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-10
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
314000000X
ID135140314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID135140Medicare Oscar/Certification