institution
South Park, Inc.
Intellectual Disabilities Intermediate Care Facility in Pocatello, Idaho
NPI 1205056538

South Park, Inc. is a Intellectual Disabilities Intermediate Care Facility based in Pocatello, ID. South Park, Inc. practices in Pocatello, ID. The NPI Number for South Park, Inc. is 1205056538 and holds a License No. 00259810 (Idaho).

The current practice location address for South Park, Inc. is 1722 Church Hill Downs, Pocatello, ID and can be reached out via phone at 208-237-2010.

Location: 1722 Church Hill Downs, Pocatello, ID, 83204-3303
institution
Provider Profile Details
NPI Number
1205056538
Provider Name
South Park, Inc.
Credential
Provider Entity Type
Organization
Address
1722 Church Hill Downs, Pocatello, ID, 83204-3303
Phone Number
208-237-2010
Fax Number
Provider Enumeration Date
04/27/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1722 Church Hill Downs
City
State
Zip
83201
Phone Number
208-237-2010
Fax Number
person
Provider Business Mailing Address Details
Address
1722 Church Hill Downs
City
State
Zip
83201
Phone Number
208-237-2010
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
License No.
00259810 (Idaho)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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