Meridian Developmental Center, Inc.

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

MERIDIAN DEVELOPMENTAL CENTER, INC.

Practice address

40 W Franklin Rd Ste I
Meridian, ID 83642-2992

Phone

(208) 888-6068

Fax

(208) 888-6055

NPI assigned

Mar 30, 2007

Last updated

Aug 22, 2020By 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

Jerry R. Fowler

Title

Administrator

Phone

(208) 853-7155

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700906054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 140289",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837140289",
            "telephone_number": "208-853-7155",
            "fax_number": "208-853-7156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 W FRANKLIN RD STE I",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422992",
            "telephone_number": "208-888-6068",
            "fax_number": "208-888-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN DEVELOPMENTAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "208-853-7155"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meridian Adult Medicine, PLLC
• Meridian Chiropractic Clinic LLC
• Meridian Counseling Center (Meridian Counseling Center and Aundrea Peaslee)
• Meridian Dental, PLLC
• Meridian Dermatology PLLC
• Meridian Developmental Services LLC
• Meridian Healthcare LLC
• Meridian Healthcare LLC (Creekside Transitional Care and Rehabilitation)
• Meridian Hearing AIDS LLC (Leslie Milliken)
• Meridian Lighthouse Counseling

• Developmentally Disabled Services Day Training Agency in Meridian, ID
• Providers in Meridian, ID by specialty
• Developmentally Disabled Services Day Training Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.