National Provider Identifier Database

ST LUKES ELKS CHILDRENS REHAB
Children


Contact Information

ST. LUKE'S ELKS CHILDRENS REHAB
405 W MYRTLE ST
BOISE, ID83702-7658
Phone: 208-489-5880
Fax:
Website:
Specialty Taxonomy Code
* Children 283XC2000X

* Indicates primary specialty

NPI Profile & details for ST. LUKE'S ELKS CHILDRENS REHAB

NPI Number 1548697006
Legal business name
LBN
ST. LUKE'S ELKS CHILDRENS REHAB
Authorized official BRENT WILSON - (COMPLIANCE AND RISK MANAGEMENT)
Entity Organization
Organization subpart No
Enumeration date 09/30/2013
Last updated 09/30/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers
  • ID License #: SLP-2340

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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