SOUTHEASTERN IDAHO DEVELOPMENTAL CENTER, INC. (NPI# 1568597078) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568597078 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN IDAHO DEVELOPMENTAL CENTER, INC. |
| Practice Address |
765 W Judicial St Blackfoot ID 83221-2036 |
| Mailing Address |
Po Box 701 Blackfoot ID 83221-0701 |
| Practice Telephone | 2087821301 |
| Practice Fax Number | 2087823627 |
| Mailing Telephone | 2087821301 |
| Mailing Fax Number | 2087823627 |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JIM P. MCCOY (OWNER DIRECTOR) |
| Authorized Official Telephone | 2087821301 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251B00000X | Case Management | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629124987 | Southeastern Idaho Developmental Center, Inc. | Day Training, Developmentally Disabled Services | 765 W Judicial St, Blackfoot, ID 83221-2036 | 2007-01-26 |
| 1558535948 | Southeastern Idaho Developmental Center, Inc. | Case Management | 765 W Judicial St, Blackfoot, ID 83221-2036 | 2008-04-16 |
| 1780879700 | Southeastern Idaho Developmental Center, Inc. | Community/Behavioral Health | 765 W Judicial St, Blackfoot, ID 83221-2036 | 2007-09-12 |
| 1235264318 | Southeastern Idaho Developmental Center, Inc. | Case Management | 765 W Judicial St, Blackfoot, ID 83221-2036 | 2007-02-22 |
| Street Address |
765 W JUDICIAL ST |
| City | BLACKFOOT |
| State | ID |
| Zip Code | 83221-2036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629124987 | Southeastern Idaho Developmental Center, Inc. | Day Training, Developmentally Disabled Services | 765 W Judicial St, Blackfoot, ID 83221-2036 | 2007-01-26 |
| 1568636959 | Southeastern Idaho Developmental Center, Inc . | Case Management | 765 W Judicial St, Blackfoot, ID 83221-2036 | 2008-04-16 |
| 1558535948 | Southeastern Idaho Developmental Center, Inc. | Case Management | 765 W Judicial St, Blackfoot, ID 83221-2036 | 2008-04-16 |
| 1780879700 | Southeastern Idaho Developmental Center, Inc. | Community/Behavioral Health | 765 W Judicial St, Blackfoot, ID 83221-2036 | 2007-09-12 |
| 1235264318 | Southeastern Idaho Developmental Center, Inc. | Case Management | 765 W Judicial St, Blackfoot, ID 83221-2036 | 2007-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932711165 | Samantha Paige Averett | Social Worker | 60 N Broadway, Blackfoot, ID 83221 | 2020-08-19 |
| 1730711656 | Sara Marie Letham | Family Medicine | 33 S Thompson Lane, Blackfoot, ID 83221 | 2020-02-08 |
| 1962994962 | Tyler Thomas Wood | Student in an Organized Health Care Education/Training Program | 98 Poplar Street, Blackfoot, Id 83221, Blackfoot, ID 83221 | 2018-06-05 |
| 1801336276 | Bmh, Inc. | Internal Medicine | 235 Poplar St, Blackfoot, ID 83221 | 2017-03-03 |
| 1497119804 | Susan Doran | Social Worker | 720 E. Alice, Blackfoot, ID 83221 | 2016-04-12 |
| 1427412121 | Josie Russell Adkins | Counselor | 720 East Alice, Blackfoot, ID 83221 | 2016-04-08 |
| 1740590314 | Ashley Nichole Thomas | Physician Assistant | 710 E. Alice Street, Blackfoot, ID 83221 | 2010-10-18 |
| 1528373313 | Stephanie Lynn Henderson | Dietitian, Registered | 1555 Vernon Ave, Blackfoot, ID 83221 | 2010-08-17 |
| 1184850141 | Joy H. Taylor | Nurse Practitioner | 1441 Parkway Drive, Blackfoot, ID 83221 | 2009-06-04 |
| 1427232925 | Nathan E. Sneddon | Anesthesiology | 98 Poplar St Fl 3, Blackfoot, ID 83221 | 2007-12-20 |
| Find all providers in zip 83221 | ||||
| Taxonomy Code | 251B00000X |
| Grouping | Agencies |
| Classification | Case Management |
| An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275638645 | Stillwaters Counseling LLC | Case Management | 1309 Camas St, Blackfoot, ID 83221-3060 | 2006-09-13 |
| 1144857251 | Robinson and Affiliates, Inc. | Case Management | 131 W Bridge St, Blackfoot, ID 83221-2704 | 2020-03-26 |
| 1275177503 | Still Waters Counseling LLC | Case Management | 1309 Camas St, Blackfoot, ID 83221-3060 | 2019-10-30 |
| 1568636959 | Southeastern Idaho Developmental Center, Inc . | Case Management | 765 W Judicial St, Blackfoot, ID 83221-2036 | 2008-04-16 |
| 1558535948 | Southeastern Idaho Developmental Center, Inc. | Case Management | 765 W Judicial St, Blackfoot, ID 83221-2036 | 2008-04-16 |
| 1407979123 | Dawn Enterprises Inc. | Case Management | 280 Cedar St, Blackfoot, ID 83221-1600 | 2007-04-09 |
| 1750404471 | Dawn Enterprises Inc. | Case Management | 280 Cedar St, Blackfoot, ID 83221-1600 | 2007-04-09 |
| 1730202458 | Dawn Enterprises Inc. | Case Management | 280 Cedar St, Blackfoot, ID 83221-1600 | 2007-04-09 |
| 1609990274 | J&m Mental Health, Inc. | Case Management | 60 N Broadway St, Blackfoot, ID 83221-2706 | 2007-03-19 |
| 1629107867 | Family Pathways Cooperative | Case Management | 75 Lilac St, Blackfoot, ID 83221-1768 | 2007-03-05 |
| Find all providers in BLACKFOOT | ||||
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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.