OrganizationActive
State of Idaho
NPI 1316063787 · Intellectual Disabilities Intermediate Care Facility · Nampa, ID
Provider details
- NPI number
- 1316063787
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Sue Broetje, Administrative Director(208) 442-2812
- License
- 01 (ID)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
1660 11th Ave N
Nampa, ID 83687-5000
Phone: (208) 442-2812
Fax: (208) 467-5978
Approximate (ZIP-level) locationGet directions
Mailing address
1660 11th Ave N
Nampa, ID 83687-5000
Other names (DBA / former)
- Doing business as
- Dhw Idaho State School and Hopsital
Registry dates
- Enumerated
- 2007-03-21
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.