South Park, Inc. in Pocatello - Case Management
South Park, Inc. - NPI 1821203498
South Park, Inc. is a Case Management in Pocatello, Idaho. South Park, Inc. practices all healthcare services and medical treatments related to Case Management. The NPI Number for South Park, Inc. is 1821203498. The last update date is 2020-08-22.
South Park, Inc.'s current location address is 415 S Arthur Ave, Pocatello, Idaho. You can contact this provider via phone number 2082336833 and fax number 2082336842. The mailing address for South Park, Inc. is 415 S Arthur Ave, Pocatello, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | South Park, Inc. |
|---|---|
| Address | 415 S Arthur Ave, Pocatello, Idaho |
| Phone Number | 2082336833 |
| Fax Number | 2082336842 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | EXECUTIVE |
|---|---|
| Authorized Official Name | Mccoy C Russell |
| Credentials | M.A.ED |
| Telephone Number | 2082336833 |
NPI Number Detail
| NPI Number | 1821203498 |
|---|---|
| Provider Enumeration Date | 2007-05-14 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 415 S Arthur Ave |
|---|---|
| City | Pocatello |
| State | Idaho (ID) |
| Post Code | 832043303 |
| Phone Number | 2082336833 |
| Fax Number | 2082336842 |
Provider's Primary Taxonomy Detail
| Speciality | Case Management |
|---|---|
| Taxonomy | 251B00000X |
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Definition: 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 |
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What is the unique identifier code issued to South Park, Inc. by the Centers for Medicare & Medicaid Services (CMS)?
The South Park, Inc. has been assigned the NPI (National Provider Identifier) 1821203498. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you share the physical location details of South Park, Inc.?
The South Park, Inc. is situated at 415 S Arthur Ave, in the city of Pocatello, state of ID, with the zip code 832043303.
What is the South Park, Inc.'s specialty and taxonomy code?
The South Park, Inc.'s specialty is Case Management, and the corresponding taxonomy code is 251B00000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1821203498 to South Park, Inc.?
The Centers for Medicare & Medicaid Services assigned the 1821203498 to South Park, Inc. on 2007-05-14.
As of what date were the details related to South Park, Inc. most recently updated or revised?
The information pertaining to South Park, Inc., including its address, specialty, and other relevant details, was last updated or revised on 2020-08-22.