Grand Teton Service Group in Idaho Falls - Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Grand Teton Service Group - NPI 1578724910
Grand Teton Service Group is a Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities in Idaho Falls, Idaho. Grand Teton Service Group practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The NPI Number for Grand Teton Service Group is 1578724910. The last update date is 2008-06-18.
Grand Teton Service Group's current location address is Po Box 50457, Idaho Falls, Idaho. You can contact this provider via phone number 2085287443 and fax number 2085293134. The mailing address for Grand Teton Service Group is Po Box 50457, Idaho Falls, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Grand Teton Service Group |
|---|---|
| Address | Po Box 50457, Idaho Falls, Idaho |
| Phone Number | 2085287443 |
| Fax Number | 2085293134 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PROGRAM DI |
|---|---|
| Authorized Official Name | Bowman Lisa |
| Credentials | BA |
| Telephone Number | 2085287443 |
NPI Number Detail
| NPI Number | 1578724910 |
|---|---|
| Provider Enumeration Date | 2008-06-18 |
| Last Updated Date | 2008-06-18 |
Provider Mailing Address Detail
| Address | Po Box 50457 |
|---|---|
| City | Idaho Falls |
| State | Idaho (ID) |
| Post Code | 834050457 |
| Phone Number | 2085287443 |
| Fax Number | 2085293134 |
Provider's Primary Taxonomy Detail
| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
|---|---|
| Taxonomy | 320900000X |
| Licence No | 806915000 |
|
Definition: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities. |
|
Post Comment/ Review Below
What is the Grand Teton Service Group's 1578724910?
The Grand Teton Service Group's NPI (National Provider Identifier) Number is 1578724910. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Grand Teton Service Group is physically located?
The Grand Teton Service Group is situated at the following address: Po Box 50457, Idaho Falls, ID 834050457.
What is Grand Teton Service Group's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Grand Teton Service Group's specialized field of practice is Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the corresponding taxonomy code that categorizes this area of specialization is 320900000X.
On what date did Grand Teton Service Group receive its 1578724910 assignment from the Centers for Medicare & Medicaid Services?
The Grand Teton Service Group was assigned its 1578724910 on 2008-06-18, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Grand Teton Service Group most recently updated?
The details pertaining to the Grand Teton Service Group, including its address, specialty, and other relevant information, were last refreshed on 2008-06-18.
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