Organization Name: | STATE HOSPITAL NORTH |
NPI Number: | 1598831653 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT BOURASSA (ADMINISTRATIVE DIRECTOR) |
Mailing Address: | 300 Hospital Dr Orofino |
State: | ID US |
Postal Code: | 835449034 |
Phone Number: | 2084764511 |
Fax Number: | 2084767898 |
NPI Enumeration Date: | 11/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 283Q00000X |
License Number: | 24 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Hospitals |
Taxonomy Classification: | Psychiatric Hospital |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |