SOUTH PARK, INC. (NPI# 1194930768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194930768 |
| Entity Type | Organization |
| Organization Name | SOUTH PARK, INC. |
| Other Organization Name | DEVELOPMENTAL OPTIONS |
| Practice Address |
415 S Arthur Ave Pocatello ID 83204-3303 |
| Practice Telephone | 2082336833 |
| Practice Fax Number | 2082336842 |
| Mailing Telephone | 2082336833 |
| Mailing Fax Number | 2082336842 |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | RUSSELL C MCCOY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2082336833 |
| Authorized Official Credential | M.A.ED |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251J00000X | Nursing Care | ID | Agencies |
| Other Name | Type Code |
|---|---|
| Developmental Options | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134340011 | South Park, Inc. | Intermediate Care Facility, Mentally Retarded | 3875 Bannock Hwy, Pocatello, ID 83204-4405 | 2007-05-01 |
| 1205056538 | South Park, Inc. | Intermediate Care Facility, Mentally Retarded | 1722 Church Hill Downs, Pocatello, ID 83201 | 2007-04-27 |
| 1295954139 | South Park, Inc. | Intermediate Care Facility, Mentally Retarded | 2369 Rulon Ave, Pocatello, ID 83201-1881 | 2007-04-25 |
| 1437291044 | South Park, Inc. | Case Management | 415 S Arthur Ave, Pocatello, ID 83204-3303 | 2007-02-12 |
| 1003021676 | South Park, Inc. | Case Management | 415 S Arthur Ave, Pocatello, ID 83204-3303 | 2007-05-14 |
| 1912112582 | South Park, Inc. | Case Management | 415 S Arthur Ave, Pocatello, ID 83204-3303 | 2007-05-14 |
| 1821203498 | South Park, Inc. | Case Management | 415 S Arthur Ave, Pocatello, ID 83204-3303 | 2007-05-14 |
| Street Address |
415 S ARTHUR AVE |
| City | POCATELLO |
| State | ID |
| Zip Code | 83204-3303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437291044 | South Park, Inc. | Case Management | 415 S Arthur Ave, Pocatello, ID 83204-3303 | 2007-02-12 |
| 1003021676 | South Park, Inc. | Case Management | 415 S Arthur Ave, Pocatello, ID 83204-3303 | 2007-05-14 |
| 1912112582 | South Park, Inc. | Case Management | 415 S Arthur Ave, Pocatello, ID 83204-3303 | 2007-05-14 |
| 1821203498 | South Park, Inc. | Case Management | 415 S Arthur Ave, Pocatello, ID 83204-3303 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568974541 | Daniel Graham Rasmussen | Social Worker | 335 N. Main, Pocatello, ID 83204 | 2017-10-30 |
| 1801311246 | Thomas Henrie | Specialist/Technologist | 3960 Stockman Rd., Pocatello, ID 83204 | 2017-08-07 |
| 1750803110 | David Tim Williams | Counselor | 224 S. Arthur Suite 2, Pocatello, ID 83204 | 2017-07-07 |
| 1023441185 | Insight Occupational Therapy, LLC | Occupational Therapist | 158 N Main St., Pocatello, ID 83204 | 2013-08-13 |
| 1679816912 | A New Hope, LLC | Day Training, Developmentally Disabled Services | 19b Mountain Dr, Pocatello, ID 83204 | 2013-04-05 |
| 1790032431 | Wynnona Sarah Warren | Pharmacist | 911 North Main Street, Pocatello, ID 83204 | 2012-08-13 |
| 1902110380 | Belmont Management, Inc. | Intermediate Care Facility, Mentally Retarded | 6150 S. 5th Ave, Pocatello, ID 83204 | 2010-07-28 |
| 1104066539 | Rachel Ann Seibold | Speech-Language Pathologist | 1254 Swisher Rd, Pocatello, ID 83204 | 2009-02-25 |
| 1710163803 | Allen Bennett Martin | Clinic/Center | 540 South Garfield, Pocatello, ID 83204 | 2008-01-18 |
| 1174711758 | Rsm Pa Pllc | Physician Assistant | 1595 Bannock Hwy, Pocatello, ID 83204 | 2007-10-09 |
| Find all providers in zip 83204 | ||||
| Taxonomy Code | 251J00000X |
| Grouping | Agencies |
| Classification | Nursing Care |
| A Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750921698 | Rocky Mountain Psychiatry | Nursing Care | 333 W Cedar St Ste 3, Pocatello, ID 83201-5045 | 2020-01-08 |
| 1013115500 | Need-a-nurse Medical Staffing, LLC | Nursing Care | 215 N 9th Ave, Pocatello, ID 83201-5278 | 2007-07-05 |
| 1689708471 | First Choice Home Care and Staffing | Nursing Care | 690 Yellowstone Ave, Suite D, Pocatello, ID 83201-4540 | 2007-03-15 |
| 1083769798 | Community Wellness Center, Inc | Nursing Care | 1509 N Arthur Ave, Pocatello, ID 83204 | 2007-01-24 |
| 1811477813 | A New Hope, LLC | Nursing Care | 300 N 7th Ave, Pocatello, ID 83201-5705 | 2018-08-19 |
| 1285170050 | Prohealth Home Care Services, Inc. | Nursing Care | 936 E Center St, Pocatello, ID 83201-5702 | 2017-01-17 |
| 1407161631 | Belmont Management, Inc. | Nursing Care | 3625 Vaughn Ave, Pocatello, ID 83204-2062 | 2010-08-12 |
| 1639391881 | Belmont Management, Inc. | Nursing Care | 3625 Vaughn Ave, Pocatello, ID 83204-2062 | 2007-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376913954 | C&r, Inc | Nursing Care | 1107 Logan St, Moscow, ID 83843-3124 | 2015-09-25 |
| 1962887000 | Aspen Personal Care Service LLC. | Nursing Care | 310 E Highway 200 Suite 1, Clark Fork, ID 83811 | 2015-07-29 |
| 1295121499 | Rescare Washington Inc | Nursing Care | 136 N Broadmore Way Ste 101, Nampa, ID 83687-5187 | 2015-04-14 |
| 1871922823 | Ideal Nursing Solutions LLC | Nursing Care | 15702 Riverside Rd, Caldwell, ID 83607-9628 | 2013-11-09 |
| 1447565551 | Yellowstone Care Center, Inc. | Nursing Care | 540 W Sunnyside, Idaho Falls, ID 83402 | 2010-08-12 |
| 1346479391 | Best Homecare and Staffing LLC | Nursing Care | 16211 N Brinson St Ste 130, Nampa, ID 83687-5520 | 2009-07-13 |
| 1750567590 | Back To Basic Living Res.hab. | Nursing Care | 150 Atlantic St, Twin Falls, ID 83301-5548 | 2008-01-10 |
| 1629252994 | Qualicare Inc. | Nursing Care | 3539 Briar Creek Ln, Suite A, Ammon, ID 83406-4761 | 2007-12-21 |
| 1164623484 | Yellowstone Care Center, Inc. | Nursing Care | 560 W Sunnyside Rd, Idaho Falls, ID 83402-4641 | 2007-05-31 |
| 1902027303 | Preferred Community Homes, LLC | Nursing Care | 7091 W Emerald St, Boise, ID 83704-8618 | 2007-05-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.