Idaho Vacation Rentals LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

IDAHO VACATION RENTALS LLC

Doing business as

JC Safe and Sober Living Facility

Practice address

227 W 19TH St
Idaho Falls, ID 83402-4438

Phone

(208) 360-9992

NPI assigned

Sep 3, 2024

Organization subpart

Yes

Parent organization

IDAHO VACATION RENTALS LLCAs reported in NPPES

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

Authorized official

Name

Daren Clint Long

Title

Program Manager

Phone

(208) 360-9992

Specialties & licenses 1

Addresses

Other names 1

• JC Safe and Sober Living Facility Doing business as

Part of

Idaho Vacation Rentals LLC

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

{
    "created_epoch": "1725321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725321600000",
    "number": "1689409500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673 10TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834045002",
            "telephone_number": "208-360-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 W 19TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834024438",
            "telephone_number": "208-360-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO VACATION RENTALS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IDAHO VACATION RENTALS LLC",
        "enumeration_date": "2024-09-03",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "DAREN",
        "authorized_official_middle_name": "CLINT",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "208-360-9992"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JC Safe and Sober Living Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Behavioral Health Agency in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Community/Behavioral Health Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; 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.