Bannock County Juvenile Justice
Organization Active NPI Case Management Agency · Pocatello, ID
NPI 1982895884 · NPPES record last updated Aug 6, 2007
Key facts
- NPI
- 1982895884
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Case Management Agency 251B00000X
- Legal business name
- BANNOCK COUNTY JUVENILE JUSTICE
- Practice address
- 624 E Center St
Pocatello, ID 83201-6274 - Phone
- (208) 236-0606
- Fax
- (208) 234-1094
- NPI assigned
- Aug 6, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Matt Olsen, MSW
- Title
- Juvenile Justice Director
- Phone
- (208) 236-0606
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- Bannock County Amb Dist
Locations
624 E Center St
Pocatello, ID 83201
Phone (208) 236-0606
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | ID | Yes |
Addresses
Primary practice location
624 E Center St
Pocatello, ID 83201-6274
Mailing address
624 E Center St
Pocatello, ID 83201-6274
Phone (208) 236-0606
Other providers in Pocatello, ID
- Mark Ensio Baker
- Jenny May Ball
- Joette Ballard
- Bannock County Ambulance District
- Bannock County Family Treatment Center
- Bannock Inpatient Services PLLC
- Bannock Youth Foundation
- Sarah Nicolle Baquet
- Daniel McLean Barclay
- Jeffery B. Barfuss
All providers in Pocatello, ID · Case Management Agency in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.