Gem State Developmental Center Llc in Meridian - Day Training, Developmentally Disabled Services
Gem State Developmental Center Llc - NPI 1760523062
Gem State Developmental Center Llc is a Day Training, Developmentally Disabled Services in Meridian, Idaho. Gem State Developmental Center Llc practices all healthcare services and medical treatments related to Day Training, Developmentally Disabled Services. The NPI Number for Gem State Developmental Center Llc is 1760523062. The last update date is 2019-10-22.
Gem State Developmental Center Llc's current location address is 818 Nw 15th St, Meridian, Idaho. You can contact this provider via phone number 2088885566 and fax number 2088885578. The mailing address for Gem State Developmental Center Llc is 818 Nw 15th St, Meridian, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Gem State Developmental Center Llc |
|---|---|
| Address | 818 Nw 15th St, Meridian, Idaho |
| Phone Number | 2088885566 |
| Fax Number | 2088885578 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | Poole Jo Lori |
| Credentials | LCSW |
| Telephone Number | 2088885565 |
NPI Number Detail
| NPI Number | 1760523062 |
|---|---|
| Provider Enumeration Date | 2007-02-09 |
| Last Updated Date | 2019-10-22 |
Provider Mailing Address Detail
| Address | 818 Nw 15th St |
|---|---|
| City | Meridian |
| State | Idaho (ID) |
| Post Code | 836423724 |
| Phone Number | 2088885566 |
| Fax Number | 2088885578 |
Provider's Primary Taxonomy Detail
| Speciality | Day Training, Developmentally Disabled Services |
|---|---|
| Taxonomy | 251C00000X |
| Licence No | 3GEM043 |
|
Definition: 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 |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 806276000 | ID | -- | |
| 2571100 | ID | -- | |
| 806782800 | ID | -- | |
| 2570900 | ID | -- |
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What is the Gem State Developmental Center Llc's 1760523062?
The Gem State Developmental Center Llc's NPI (National Provider Identifier) Number is 1760523062. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Gem State Developmental Center Llc?
The Gem State Developmental Center Llc is situated at 818 Nw 15Th St, in the city of Meridian, state of ID, with the zip code 836423724.
What is the area of specialization for Gem State Developmental Center Llc, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Gem State Developmental Center Llc is Day Training, Developmentally Disabled Services, and the corresponding taxonomy code that categorizes this area of expertise is 251C00000X.
On what date did the Gem State Developmental Center Llc receive its 1760523062 assignment from the Centers for Medicare & Medicaid Services?
The Gem State Developmental Center Llc was assigned its 1760523062 by the Centers for Medicare & Medicaid Services on 2007-02-09.
As of what date were the Gem State Developmental Center Llc's details last updated?
The information pertaining to the Gem State Developmental Center Llc, including its address, specialty, and other details, was most recently updated on 2019-10-22.
NPI Number: 1225026222
Address: 300 Twining St Bldg 760, Maxwell Afb, AL