NPI 1023667524
Gem State Developmental Center LLC
Practice location
- Address
- 818 NW 15th St, Meridian, ID 83642-3724
- Phone
- (208) 888-5566
- Fax
- (208) 888-5578
Authorised official
- Name
- Lori Jo Poole
- Title
- Clinical Director
- Phone
- (208) 888-5566
Registered specialties
Day Training/Habilitation Specialist
Primary
Registry record
- NPI
- 1023667524
- Entity type
- Organization
- NPI issued
- 6 Sep 2019
- Record last updated
- 6 Sep 2019
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.