NPI 1629124987

Southeastern Idaho Developmental Center, INC.

Organisation Developmentally Disabled Services Day Training Agency Blackfoot, ID

Practice location

Address: 765 W Judicial St, Blackfoot, ID 83221-2036
Phone: (208) 782-1301
Fax: (208) 782-3627
Mailing address: PO Box 701, Blackfoot, ID 83221-0701

Authorised official

Name: Jim P. McCoy
Title: Owner Director
Phone: (208) 782-1301

Registered specialties

Developmentally Disabled Services Day Training Agency Primary

Agencies Taxonomy 251C00000X Licence 6SOEAST035 (ID)

Other Day Training, Developmentally Disabled Services providers in Idaho →

Registry record

NPI: 1629124987
Entity type: Organization
NPI issued: 26 Jan 2007
Record last updated: 20 Mar 2008

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.