Latino Stand Up

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

LATINO STAND UP

Practice address

1420 E 17TH St
Suite a
Idaho Falls, ID 83404-6283

Phone

(208) 313-0711

NPI assigned

Dec 31, 2012

Last updated

Dec 31, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Roman Cruz

Title

Owner

Phone

(208) 313-0711

Specialties & licenses 2

Addresses

Tax ID family

Latino Stand Up2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Latino Stand Up

  • Adolescent and Children Mental Health Clinic/Center
  • Idaho Falls, ID
  • NPI 1164781365
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1356912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356912000000",
    "number": "1306182910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 E 17TH ST",
            "address_2": "SUITE A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046283",
            "telephone_number": "208-313-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 E 17TH ST",
            "address_2": "SUITE A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046283",
            "telephone_number": "208-313-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LATINO STAND UP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-31",
        "last_updated": "2012-12-31",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "ROMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-313-0711",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Larson
• Tyler J. Larson, DPT
• Kari Anne Lasco-Sanders, DPT
• Ricky Dwayne Latham, MD
• Latino Stand Up
• Latino Stand Up Idaho LLC (Latino Stand Up)
• Latino Stand Up Idaho LLC (Latino Stand Up LLC)
• Gary J Lattimore, OD
• Danielle Lauricella, PHD, LMFT
• Nathan Joel Lausch

• Case Management Agency in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Case Management Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.