JOURNEY PEDIATRIC THERAPY NPI 1023487105

NPI Information

NPI: 1023487105
Provider Name: JOURNEY PEDIATRIC THERAPY
Classification: Clinic/Center - 261QR0400X
Entity Type: Organization

Specialization: Rehabilitation

Address:
506 ALDER ST FL 2
SANDPOINT, ID
ZIP 83864
Phone: (208) 627-8615
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JOURNEY PEDIATRIC THERAPY is a rehabilitation clinic center in Sandpoint, ID. JOURNEY PEDIATRIC THERAPY NPI is 1023487105. The provider is registered as an organization entity type.

The provider's business location address is:

506 ALDER ST FL 2
SANDPOINT, ID
ZIP 83864-567
Phone: (208) 627-8615

The provider's authorized official is Maresa Black .
The authorized official title is Occupational Therapist And Owner and has the following contact phone number (208) 627-8615.

The enumeration date for this NPI number is 9/18/2015 and was last updated on 1/20/2016.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0400X	Clinic/Center	Rehabilitation	OT-1405	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1750758702	MEDICAID	IDAHO

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

NPI Synchronization or Removal

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