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SOUTH PARK INC. NPI 1194930768


NPI Information

NPI: 1194930768
Provider Name: SOUTH PARK, INC.

Doing Business As: DEVELOPMENTAL OPTIONS

Classification: Nursing Care - 251J00000X
Entity Type: Organization
Address:
415 S ARTHUR AVE
POCATELLO, ID
ZIP 83204
Phone: (208) 233-6833
Get Directions

SOUTH PARK, INC. is a nursing care in Pocatello, ID. The provider is a Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services. SOUTH PARK, INC. NPI is 1194930768. The provider is registered as an organization entity type.
The provider Is Doing Business As Developmental Options.

The provider's business location address is:

415 S ARTHUR AVE
POCATELLO, ID
ZIP 83204-303
Phone: (208) 233-6833
Fax: (208) 233-6842

The provider's authorized official is Russell C Mccoy .
The authorized official title is Executive Director and has the following contact phone number (208) 233-6833.

The enumeration date for this NPI number is 5/14/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251J00000XNursing CareIDAHOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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