National Provider Identifier Database

ST LUKES ELKS CHILDRENS REHABILITATION
Children


Contact Information

ST LUKE'S ELKS CHILDREN'S REHABILITATION
3525 E LOUISE DR
SUITE 255
MERIDIAN, ID83642-6302
Phone: 208-489-5099
Fax:
Website:
Specialty Taxonomy Code
* Children 283XC2000X

* Indicates primary specialty

NPI Profile & details for ST LUKE'S ELKS CHILDREN'S REHABILITATION

NPI Number 1457751471
Legal business name
LBN
ST LUKE'S ELKS CHILDREN'S REHABILITATION
Authorized official JOHN WELSH - (ELKS PROVIDER ENROLLMENT SPECIALIST)
Entity Organization
Organization subpart No
Enumeration date 08/27/2014
Last updated 08/27/2014 - About 12 years ago
Sole proprietor1 Not specified
Identifiers
  • ID License #: OT-963

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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