Pearl Group Homes

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

RHA-2498 Issued in ID

Legal business name

PEARL GROUP HOMES

Practice address

1740 E 17TH St
Suite a
Idaho Falls, ID 83404-6375

Phone

(208) 346-7500

Fax

(208) 346-7501

NPI assigned

Jan 20, 2011

Last updated

Jan 20, 2011By 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

Lisa Bowman, M.S.

Title

Program Director

Phone

(208) 346-7500

Specialties & licenses 1

Addresses

Tax ID family

Pearl Group Homes2 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.

• Pearl Group Homes

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Idaho Falls, ID
  • NPI 1760783153
  NPD tax ID

Locations

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

{
    "created_epoch": "1295481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295481600000",
    "number": "1811292915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 E 17TH ST",
            "address_2": "SUITE A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046375",
            "telephone_number": "208-346-7500",
            "fax_number": "208-346-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 E 17TH ST",
            "address_2": "SUITE A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046375",
            "telephone_number": "208-346-7500",
            "fax_number": "208-346-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARL GROUP HOMES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-20",
        "last_updated": "2011-01-20",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "208-346-7500",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "ID",
            "license": "RHA-2498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Dustin Payne
• Shyee Payne, PHARMD
• Terrell Payne, MOTR/L
• Peak Medical of Idaho, Inc. (Idaho Falls Care and Rehabilitation Center)
• Pearl Group Homes
• Pearl Healthcare Centers, Inc
• Bradley Dale Pearson, MPT
• Colby Pearson, DO
• William Edwin Pearson, DDS
• Dottie Peck, REEGT, CNIM

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; 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.