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Adolescent & Child Development Center, Llc
Adult Mental Health Clinic/Center in Pocatello, Idaho
NPI 1063671469

Adolescent & Child Development Center, Llc is an Adult Mental Health Clinic/Center based in Pocatello, ID and is specialized in Adult Mental Health. Adolescent & Child Development Center, Llc practices in Pocatello, ID. The NPI Number for Adolescent & Child Development Center, Llc is 1063671469 and holds a License No. 261QD1600X (Idaho).

The current practice location address for Adolescent & Child Development Center, Llc is 151 N 3Rd Ave, Pocatello, ID and can be reached out via phone at 208-232-5622 and via fax at 208-233-4639.

Location: 151 N 3Rd Ave, Pocatello, ID, 83201-6331
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1063671469
Provider Name
Adolescent & Child Development Center, Llc
Credential
Provider Entity Type
Organization
Address
151 N 3Rd Ave, Pocatello, ID, 83201-6331
Phone Number
208-232-5622
Fax Number
208-233-4639
Provider Enumeration Date
06/02/2008
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
808259000 05 ID
808257100 05 ID
808028200 05 ID
institution
Provider Business Practice Location Address Details
Address
151 N 3Rd Ave
City
Pocatello
State
Idaho
Zip
83201-6331
Phone Number
208-232-5622
Fax Number
208-233-4639
person
Provider Business Mailing Address Details
Address
151 N 3Rd Ave
City
Pocatello
State
Idaho
Zip
83201-6331
Phone Number
208-232-5622
Fax Number
208-233-4639
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Developmental Disabilities
Taxonomy
261QD1600X
License No.
261QM0850X (Idaho)
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 instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
261QM0801X (Idaho)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
261QM0850X
License No.
261QD1600X (Idaho)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
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