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Lucas Smith
Child Intellectual and/or Developmental Disabilities Respite Care in Blackfoot, Idaho
NPI 1083480404

Lucas Smith is a Child Intellectual and/or Developmental Disabilities Respite Care based in Blackfoot, ID and is specialized in Respite Care, Intellectual and/or Developmental Disabilities, Child. Lucas Smith practices in Blackfoot, ID. The NPI Number for Lucas Smith is 1083480404 and holds a License No. (Idaho).

The current practice location address for Lucas Smith is 861 Lakeside Dr, Blackfoot, ID and can be reached out via phone at 208-360-7355.

Location: 861 Lakeside Dr, Blackfoot, ID, 83221-1674
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1083480404
Provider Name
Lucas Smith
Credential
Provider Entity Type
Individual
Gender
Male
Address
861 Lakeside Dr, Blackfoot, ID, 83221-1674
Phone Number
208-360-7355
Fax Number
Provider Enumeration Date
11/27/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
861 Lakeside Dr
City
Blackfoot
State
Idaho
Zip
83221-1674
Phone Number
208-360-7355
Fax Number
person
Provider Business Mailing Address Details
Address
861 Lakeside Dr
City
Blackfoot
State
Idaho
Zip
83221-1674
Phone Number
208-360-7355
Fax Number
person
Provider's Taxonomy Details 1
Type
Respite Care Facility
Classification
Respite Care
Speciality
Respite Care, Intellectual and/or Developmental Disabilities, Child
Taxonomy
385HR2060X
License No.
()
Definition
A facility or distinct part of a facility that provides short term, residential care to children diagnosed with intellectual and/or developmental disabilities as respite for the regular caregivers.
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