Developmental Options

LBN: South Park, Inc.
Developmental Options is an health care organization with primary practice located at 415 S Arthur Ave , Pocatello ID 83204-3303. The organization recently has 2 registered licenses in different health care specialties including Agencies / Case Management, Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded. Agencies / Case Management is the primary health care specialty. South Park, Inc. can be contacted via phone (208) 233-6833, or through Mccoy, Russell C via phone (208) 233-6833.

Contact Information

Primary practice address
415 S Arthur Ave Pocatello ID 83204-3303
Phone: (208) 233-6833
Fax: (208) 233-6842
Website:
Map and Directions
Authorized official contact:
Name: Mccoy, Russell C M.A.ED
Phone: (208) 233-6833

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X Idaho
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 15 Idaho
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 20 Idaho
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 43 Idaho

Profile Details

NPI number 1437291044
LBN Legal business name South Park, Inc.
DBA Doing business as Developmental Options
Authorized official Mccoy, Russell C M.A.ED
Entity Organization
Organization subpart 1 No
Enumeration date Feb 12th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437291044 NPPES
Idaho MEDICAID 00259810
Idaho MEDICAID 00259800
Idaho MEDICAID 00259790

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