NPIMap

Organization Active NPI

Idaho Falls Group Homes

  • Intellectual Disabilities Intermediate Care Facility
  • Idaho Falls, ID
National Provider Identifier
1760686687
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
45 Issued in ID
Legal business name
IDAHO FALLS GROUP HOMES
Practice address
950 Periska Way
Idaho Falls, ID 83402-5141
Phone
(208) 524-6420
NPI assigned
Jun 13, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Rex Redden
Title
Administrator
Phone
(208) 523-0053

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 45 ID Primary

Addresses

Primary practice location

950 Periska Way
Idaho Falls, ID 83402-5141

Mailing address

PO Box 50457
Idaho Falls, ID 83405-0457

National Provider Directory

National Provider Directory
Tax ID family
Idaho Falls Group Homes4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760686687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50457",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834050457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 PERISKA WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834025141",
            "telephone_number": "208-524-6420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO FALLS GROUP HOMES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REDDEN",
        "authorized_official_first_name": "REX",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "208-523-0053",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "ID",
            "license": "45",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • 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.