NPI 1417062274 · live from the CMS NPI Registry
Creekside Hospice INC.
Hospice Care, Community Based in Pocatello, ID. National Provider Identifier 1417062274, active.
NPI record
| NPI | 1417062274 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Hospice Care, Community Based 251G00000X |
| Practice location | 1246 Yellowstone Ave Ste C5, Pocatello, ID 83201 |
| Practice phone | 208-637-1100 |
| Mailing address | Po Box 65788, Salt Lake City, UT 84165 |
| Enumerated | August 20, 2006 |
| Last updated | August 22, 2020 |
| Authorized official | Robert Breinholt, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Hospice Care, Community Based primary | 251G00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.