Adolescent & Child Development Center, Llc in Pocatello - Developmental Disabilities
Adolescent & Child Development Center, Llc - NPI 1063671469
Adolescent & Child Development Center, Llc is a Developmental Disabilities in Pocatello, Idaho. Adolescent & Child Development Center, Llc practices all healthcare services and medical treatments related to Developmental Disabilities. The NPI Number for Adolescent & Child Development Center, Llc is 1063671469. The last update date is 2009-04-02.
Adolescent & Child Development Center, Llc's current location address is 151 N 3rd Ave, Pocatello, Idaho. You can contact this provider via phone number 2082325622 and fax number 2082334639. The mailing address for Adolescent & Child Development Center, Llc is 151 N 3rd Ave, Pocatello, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Adolescent & Child Development Center, Llc |
|---|---|
| Address | 151 N 3rd Ave, Pocatello, Idaho |
| Phone Number | 2082325622 |
| Fax Number | 2082334639 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER/EXEC |
|---|---|
| Authorized Official Name | Walker Ray Vance |
| Telephone Number | 2082325622 |
NPI Number Detail
| NPI Number | 1063671469 |
|---|---|
| Provider Enumeration Date | 2008-06-02 |
| Last Updated Date | 2009-04-02 |
Provider Mailing Address Detail
| Address | 151 N 3rd Ave |
|---|---|
| City | Pocatello |
| State | Idaho (ID) |
| Post Code | 832016331 |
| Phone Number | 2082325622 |
| Fax Number | 2082334639 |
Provider's Primary Taxonomy Detail
| Speciality | Developmental Disabilities |
|---|---|
| Taxonomy | 261Qd1600X |
| Licence No | 261QD1600X |
|
Definition: An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many ins |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 808259000 | ID | -- | |
| 808257100 | ID | -- | |
| 808028200 | ID | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Adolescent & Child Development Center, Llc by the Centers for Medicare & Medicaid Services?
The Adolescent & Child Development Center, Llc has been issued the NPI (National Provider Identifier) 1063671469 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Adolescent & Child Development Center, Llc's facilities are geographically located?
The facilities of Adolescent & Child Development Center, Llc are physically situated at the following location: 151 N 3Rd Ave, Pocatello, ID, 832016331.
What is Adolescent & Child Development Center, Llc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Adolescent & Child Development Center, Llc's area of specialization is Developmental Disabilities, and the corresponding taxonomy code that categorizes this field of practice is 261Qd1600X.
On what date did Adolescent & Child Development Center, Llc receive its 1063671469 assignment from the Centers for Medicare & Medicaid Services?
The Adolescent & Child Development Center, Llc was assigned its 1063671469 on 2008-06-02, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the Adolescent & Child Development Center, Llc's information last updated?
The Adolescent & Child Development Center, Llc's information was last updated on 2009-04-02.
NPI Number: 1457354235
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