Organization Name: | GOODING REHAB AND LIVING CENTER |
NPI Number: | 1023096757 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STACY LYNN SCHOONOVER (ADMINISTRATOR) |
Mailing Address: | 1220 Montana St Gooding |
State: | ID US |
Postal Code: | 833301856 |
Phone Number: | 2089345601 |
Fax Number: | 2089348154 |
NPI Enumeration Date: | 01/03/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310500000X |
License Number: | 38 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Intermediate Care Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. |