IndividualActive
Spencer Olson
NPI 1407572118 · Child Intellectual and/or Developmental Disabilities Respite Care · Shelley, ID
Provider details
- NPI number
- 1407572118
- Entity type
- Individual
- Primary specialty
- Child Intellectual and/or Developmental Disabilities Respite CareRespite Care Facility
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Respite Care Facility
Practice location
205 Spruce St
Shelley, ID 83274-1441
Phone: (208) 360-4294
Approximate (ZIP-level) locationGet directions
Mailing address
205 Spruce St
Shelley, ID 83274-1441
Registry dates
- Enumerated
- 2022-10-13
- Last updated
- 2022-10-13
- Certified
- 2022-10-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.