PA
PORTNEUF ASC, LLC
Adult Day Care
OIG CLEARNPI VERIFIEDMEDICARE ACTIVE
Location
POCATELLO, ID
Licensed since
2017
Rate
—
Federal identifiers
NPI registry number1871016071
Agency details
Parent orgPOCATELLO HEALTH SYSTEM, LLC
Medicare activity
StatusActive — enrolled to order & refer
Medicare patients326
RevalidationDue 2024-10-31
Authorized official
NameSTEPHEN PETROVICH
TitleEVP
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