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LINCOLN COMMUNITY HEALTH

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Company Details

Name: LINCOLN COMMUNITY HEALTH
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Active-Current
Date of registration: 14 Sep 2010 (15 years ago)
Entity Number: 433223
Place of Formation: IDAHO
File Number: 0000433223
ZIP code: 83352
County: Lincoln County
Mailing Address: 113 S APPLE ST SHOSHONE, ID 83352

National Provider Identifier

NPI Number:
1689814980

Authorized Person:

Name:
DR. KEITH DAVIS
Role:
CEO/MEDICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
251S00000X - Community/Behavioral Health Agency
Is Primary:
Yes

Contacts:

Fax:
2088862634

Filing

Filing Name Filing Number Filing date
Initial Filing 0000433223 2010-09-14

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Date of last update: 26 Sep 2024

Sources: Idaho Secretary of State