Organization
SOUTH PARK, INC.
Active
Other names
Rulon House Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL C MCCOY M.A.ED (EXECUTIVE DIRECTOR)
(208) 233-6833
Entity
Organization
Contact information
Practice address
2369 RULON AVE, POCATELLO, ID 83201-1881
(208) 237-5538
Mailing address
415 S ARTHUR AVE, POCATELLO, ID 83204-3303
(208) 233-6833
(208) 233-6842
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
00259790
ID
Other
Enumeration date
04/25/2007
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us