| Organization Name: | CONCORDIA HEALTH CARE INC |
| NPI Number: | 1770977787 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REBECCA LOUISE TAYLOR (PRESIDENT & CEO) |
| Mailing Address: | 1200 Hospital Way Pocatello |
| State: | ID US |
| Postal Code: | 832012708 |
| Phone Number: | 2082322570 |
| Fax Number: | 2082336769 |
| NPI Enumeration Date: | 03/27/2015 |
| NPI Last Update Date: | 03/27/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 283Q00000X |
| License Number: | 59 |
| 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. |