Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
COLE SHANE ODOM
Active Sole ProprietorIntellectual Disabilities Residential Treatment Facility · NAMPA, ID
Registration Details
- NPI Number
- 1821971326
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 30, 2025 (0.72789293024458 yrs)
- Last Updated
- Jul 30, 2025
- Sole Proprietor
- Yes
Practice Information
- Address
-
3420 S. FORK AVENAMPA, ID, 83686Browse ID providers · Browse ZIP 83686
- Phone
- 2082507733
- Primary Specialty
-
Intellectual Disabilities Residential Treatment Facility
320600000X
- Additional Specialty
- Intellectual Disabilities Residential Treatment Facility
Other Intellectual Disabilities Residential Treatment Facility Providers in NAMPA, ID
| Name | Credential | NPI |
|---|---|---|
| MRS. LISA POTTS | — | 1851010425 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.