Bannock County Juvenile Justice

Primary specialty

Case Management AgencyTaxonomy code 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

Last updated

Aug 6, 2007By 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

Mr. Matt Olsen, MSW

Title

Juvenile Justice Director

Phone

(208) 236-0606

Specialties & licenses 1

Addresses

Tax ID family

Bannock County Juvenile Justice3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Bannock County Family Treatment Center

  • Addiction (Substance Use Disorder) Counselor
  • Pocatello, ID
  • NPI 1427437383
  NPD tax ID
• D6 Treatment

  • Addiction (Substance Use Disorder) Counselor
  • Pocatello, ID
  • NPI 1689218018
  NPD tax ID

Locations

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186358400000",
    "number": "1982895884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 E CENTER ST",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832016274",
            "telephone_number": "208-236-0606",
            "fax_number": "208-234-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 E CENTER ST",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832016274",
            "telephone_number": "208-236-0606",
            "fax_number": "208-234-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNOCK COUNTY JUVENILE JUSTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A",
        "authorized_official_last_name": "OLSEN",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "JUVENILE JUSTICE DIRECTOR",
        "authorized_official_telephone_number": "208-236-0606",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenny May Ball, FNP
• Joette Ballard, PHARM D
• Ashley L Ballensky, RN
• Bannock County Ambulance District
• Bannock County Family Treatment Center
• Bannock Inpatient Services PLLC
• Bannock Youth Foundation (M.K. Place)
• Sarah Nicolle Baquet, LPC
• Daniel McLean Barclay, DPT
• Jeffery B. Barfuss, BS

• Case Management Agency in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Case Management Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; 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.