SOUTH PARK, INC.
Nursing at Bannock Hwy, Pocatello, ID

License number
Idaho 00259800
Category
Nursing
Type
Intermediate Care Facility, Mentally Retarded
Owner
Name: RUSSELL C MCCOY M.A.ED
Title: EXECUTIVE DIRECTOR
Phone: (208) 233-6833
Address
Address
3875 Bannock Hwy, Pocatello, ID 83204
National Provider ID: 1134340011
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about SOUTH PARK, INC. at bizstanding.com

South Park, Inc

415 S Arthur Ave, Pocatello, ID 83204

Industry:
Apartment Building Operator
Executive Director, Principal:
Russ Mccoy (Executive Director, Principal)

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