Southeastern Idaho Developmental Center, Inc.

NPI #1629124987 in Blackfoot, Idaho

Provider Information

NPI Number
1629124987
Entity Type
Organization
Organization Name
Southeastern Idaho Developmental Center, Inc.
Primary Specialty
Day Training, Developmentally Disabled Services
Enumeration Date
Jan 26, 2007
Last Updated
Mar 20, 2008

Practice Location

Address
765 W JUDICIAL ST
State
Idaho
ZIP Code
83221-2036
Phone
(208) 782-1301

Authorized Official

Name
JIM P. MCCOY
Title
OWNER DIRECTOR
Phone
(208) 782-1301

Specialties & Taxonomy Codes

Specialty
Day Training, Developmentally Disabled Services

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