TETON SUPPORTED LIVING LLC (NPI# 1477086114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477086114 |
| Entity Type | Organization |
| Organization Name | TETON SUPPORTED LIVING LLC |
| Practice Address |
4101 N Creswell Way Boise ID 83713-2404 |
| Practice Telephone | 2083770580 |
| Practice Fax Number | 2086721388 |
| Mailing Telephone | 2083770580 |
| Mailing Fax Number | 2086721388 |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2017-04-10 |
| Authorized Official Name | JODI L COPELAND (OWNER/ADMINISTRATOR) |
| Authorized Official Telephone | 2083770580 |
| Authorized Official Credential | BSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | Agencies |
| Street Address |
4101 N CRESWELL WAY |
| City | BOISE |
| State | ID |
| Zip Code | 83713-2404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265902332 | Kidscare Home Health of Idaho, LLC | Home Health | 1835 Wildwood Street, Boise, ID 83713 | 2018-11-30 |
| 1417463928 | Kimberly Ann Bohrer | Behavioral Analyst | 12053 W Hickory Dr, Boise, ID 83713 | 2017-12-19 |
| 1407371891 | Emir Hadzic | Optometrist | 13239 W. Fernleaf St., Boise, ID 83713 | 2017-08-07 |
| 1518336650 | Alliance Physical Medicine | Nurse Practitioner | 13909 W Wainwright Drive, Boise, ID 83713 | 2015-09-18 |
| 1083038335 | Jan L Rehder | Nurse Practitioner | 13150 W Persimmon Lane, Boise, ID 83713 | 2014-02-06 |
| 1508287061 | Heather N Fox | Physician Assistant | 12273 West Mcmillan Road, Boise, ID 83713 | 2013-12-30 |
| 1659667459 | Jayson Clark | Dentist | 4274 N Eagle Road, Boise, ID 83713 | 2011-06-21 |
| 1043503659 | Steven Anthony Eckhoff | Physician Assistant | 11662 W Arlen St, Boise, ID 83713 | 2011-05-16 |
| 1790923621 | Christie Dudash Flynn | Physician Assistant | 12273 W Mcmillian Road, Boise, ID 83713 | 2009-01-30 |
| 1699930404 | Dennis J. Garpetti, Dds, P.C. | Dentist | 13108 West Persimmon Lane, Boise, ID 83713 | 2008-07-21 |
| Find all providers in zip 83713 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851734107 | Foundations for Independence LLC | Day Training, Developmentally Disabled Services | 2316 N Cole Rd Ste C, Boise, ID 83704-7365 | 2013-04-16 |
| 1700093796 | Progressive Behavior Services | Day Training, Developmentally Disabled Services | 9422 W Fairview Ave, Boise, ID 83704-8101 | 2007-05-17 |
| 1295948925 | Boise Services Group, Inc. | Day Training, Developmentally Disabled Services | 950 W State St, Boise, ID 83702-5440 | 2007-05-08 |
| 1871711598 | The Arc, Inc. | Day Training, Developmentally Disabled Services | 4402 Albion St, Boise, ID 83705-1324 | 2007-04-20 |
| 1922137355 | Progressive Behavior Services | Day Training, Developmentally Disabled Services | 9424 W Fairview Ave, Boise, ID 83704-8101 | 2007-03-02 |
| 1952437212 | Idaho Center for Autism, LLC | Day Training, Developmentally Disabled Services | 200 S Phillippi St, Boise, ID 83705-1152 | 2007-02-23 |
| 1841334885 | Employment Solutions, Inc. | Day Training, Developmentally Disabled Services | 260 S Cole Rd, Boise, ID 83709-0934 | 2007-02-15 |
| 1770715062 | Easterseals-goodwill Northern Rocky Mountain, Inc. | Day Training, Developmentally Disabled Services | 1465 S Vinnell Way, Boise, ID 83709-1659 | 2009-08-20 |
| 1730396722 | Progressive Behavior Services | Day Training, Developmentally Disabled Services | 9424 W Fairview Ave, Boise, ID 83704-8101 | 2007-05-17 |
| 1649487638 | Progressive Behavior Services | Day Training, Developmentally Disabled Services | 9424 W Fairview Ave, Boise, ID 83704-8101 | 2007-05-17 |
| Find all providers in BOISE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.