OrganizationActive
Idaho Dept of Health & Welfare Itp Region 6
NPI 1164563508 · Early Intervention Provider Agency · Pocatello, ID
Provider details
- NPI number
- 1164563508
- Entity type
- Organization
- Primary specialty
- Early Intervention Provider AgencyAgencies
- Organization subpart
- No
- Authorized official
- Mary Jones, Program Manager(208) 334-5523
Specialties & taxonomies
Agencies
- Local Education Agency (LEA)251300000X
Agencies
Practice location
421 Memorial Dr
Pocatello, ID 83201-4008
Phone: (208) 234-7900
Fax: (208) 236-6328
Approximate (ZIP-level) locationGet directions
Mailing address
421 Memorial Dr
Pocatello, ID 83201-4008
Registry dates
- Enumerated
- 2007-02-09
- Last updated
- 2013-08-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.