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Grand Teton Child Neurology
Community/Behavioral Health Agency in Idaho Falls, Idaho
NPI 1639322258

Grand Teton Child Neurology is a Community/Behavioral Health Agency based in Idaho Falls, ID. Grand Teton Child Neurology practices in Idaho Falls, ID. The NPI Number for Grand Teton Child Neurology is 1639322258 and holds a License No. (Idaho).

The current practice location address for Grand Teton Child Neurology is 2225 Teton Plz Ste B, Idaho Falls, ID and can be reached out via phone at 208-529-4300 and via fax at 208-529-1627.

Location: 2225 Teton Plz Ste B, Idaho Falls, ID, 83404-6494
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1639322258
Provider Name
Grand Teton Child Neurology
Credential
Provider Entity Type
Organization
Address
2225 Teton Plz Ste B, Idaho Falls, ID, 83404-6494
Phone Number
208-529-4300
Fax Number
208-529-1627
Provider Enumeration Date
10/28/2008
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
77234 01 ID BLUE CROSS OF IDAHO
807968700 05 ID
institution
Provider Business Practice Location Address Details
Address
2225 Teton Plz Ste B
City
Idaho Falls
State
Idaho
Zip
83404-6494
Phone Number
208-529-4300
Fax Number
208-529-1627
person
Provider Business Mailing Address Details
Address
2225 Teton Plz Ste B
City
Idaho Falls
State
Idaho
Zip
83404-6494
Phone Number
208-529-4300
Fax Number
208-529-1627
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Neurology with Special Qualifications in Child Neurology
Taxonomy
2084N0402X
License No.
()
Definition
A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.
person
Provider's Taxonomy Details 2
Type
Agencies
Classification
Community/Behavioral Health
Speciality
-
Taxonomy
251S00000X
License No.
()
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
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2225 Teton Plz Ste B,
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