IndividualActive
Tyson Hanson
NPI 1457976045 · Child Intellectual and/or Developmental Disabilities Respite Care · Sheley, ID
Provider details
- NPI number
- 1457976045
- 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
1496 N 1070 E
Sheley, ID 83274
Phone: (208) 521-1837
Approximate (ZIP-level) locationGet directions
Mailing address
315 Wind River Dr
Shelley, ID 83274-2101
Registry dates
- Enumerated
- 2020-06-10
- Last updated
- 2020-06-10
- Certified
- 2020-06-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.