The Idaho Children'S Rehabilitation Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

THE IDAHO CHILDREN'S REHABILITATION CENTER

Practice address

1975 Martha Avenue
Idaho Falls, ID 83404-7533

Phone

(208) 529-4300

Fax

(208) 529-1627

NPI assigned

Apr 2, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Matt F Smith

Title

Manager

Phone

(208) 529-4300

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1689846362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 MARTHA AVENUE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047533",
            "telephone_number": "208-529-4300",
            "fax_number": "208-529-1627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 MARTHA AVENUE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047533",
            "telephone_number": "208-529-4300",
            "fax_number": "208-529-1627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE IDAHO CHILDREN'S REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MATT",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "208-529-4300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Children'S Center
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• The Pain Management Clinic
• The Sleep Institute
• Therapeutic House Calls, P.a.
• Therapeutic Shoes Inc

• 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 Jun 24, 2008; 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.