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CANYON CREEK DEVELOPMENTAL SERVICES NPI 1477617165


NPI Information

NPI: 1477617165
Provider Name: CANYON CREEK DEVELOPMENTAL SERVICES
Classification: Day Training, Developmentally Disabled Services - 251C00000X
Entity Type: Organization
Address:
5214 CLEVELAND BLVD STE G
CALDWELL, ID
ZIP 83607
Phone: (208) 454-6266
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CANYON CREEK DEVELOPMENTAL SERVICES is a day training developmentally disabled services in Caldwell, ID. The provider is these agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. CANYON CREEK DEVELOPMENTAL SERVICES NPI is 1477617165. The provider is registered as an organization entity type.

The provider's business location address is:

5214 CLEVELAND BLVD STE G
CALDWELL, ID
ZIP 83607-713
Phone: (208) 454-6266
Fax: (208) 454-6263

The provider's authorized official is Beth A Moody .
The authorized official title is Cfo and has the following contact phone number (208) 454-6266.

The enumeration date for this NPI number is 12/20/2006 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
1251C00000XDay Training, Developmentally Disabled Services3CANCRK123IDAHOYes

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: 4/28/2024

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