Provider Demographics
NPI:1720258668
Name:HELPING HANDS SANCTUARY OF IDAHO, INC
Entity Type:Organization
Organization Name:HELPING HANDS SANCTUARY OF IDAHO, INC
Other - Org Name:HELPING HANDS OF GOODING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:BYRUM
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:PRESCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208280-280-2163
Mailing Address - Street 1:PO BOX 4837
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83205-4837
Mailing Address - Country:US
Mailing Address - Phone:208-280-2163
Mailing Address - Fax:208-904-4030
Practice Address - Street 1:1220 MONTANA ST
Practice Address - Street 2:
Practice Address - City:GOODING
Practice Address - State:ID
Practice Address - Zip Code:83330-1856
Practice Address - Country:US
Practice Address - Phone:208-934-5601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HELPING HANDS SANCTUARY OF IDAHO, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDC131521314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility