Organization
SOUTHEASTERN IDAHO DEVELOPMENTAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIM P. MCCOY (OWNER DIRECTOR)
(208) 782-1301
Entity
Organization
Contact information
Practice address
765 W JUDICIAL ST, BLACKFOOT, ID 83221-2036
(208) 782-1301
(208) 782-3627
Mailing address
PO BOX 701, BLACKFOOT, ID 83221-0701
(208) 782-1301
(208) 782-3627
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/12/2007
Last updated
09/12/2007
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up