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Grand Teton Service Group
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Idaho Falls, Idaho
NPI 1578724910

Grand Teton Service Group is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Idaho Falls, ID. Grand Teton Service Group practices in Idaho Falls, ID. The NPI Number for Grand Teton Service Group is 1578724910 and holds a License No. 806915000 (Idaho).

The current practice location address for Grand Teton Service Group is 329 Park Ave, Idaho Falls, ID and can be reached out via phone at 208-528-7443 and via fax at 208-529-3134.

Location: 329 Park Ave, Idaho Falls, ID, 83405-0457
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1578724910
Provider Name
Grand Teton Service Group
Credential
Provider Entity Type
Organization
Address
329 Park Ave, Idaho Falls, ID, 83405-0457
Phone Number
208-528-7443
Fax Number
208-529-3134
Provider Enumeration Date
06/18/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
329 Park Ave
City
Idaho Falls
State
Idaho
Zip
83402-3610
Phone Number
208-528-7443
Fax Number
208-529-3134
person
Provider Business Mailing Address Details
Address
329 Park Ave
City
Idaho Falls
State
Idaho
Zip
83402-3610
Phone Number
208-528-7443
Fax Number
208-529-3134
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
806915000 (Idaho)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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