Individual provider · Type 1 NPI
Lucas Smith
Child Intellectual and/or Developmental Disabilities Respite Care · Blackfoot, ID
NPI number
1083480404
Active
Practice location
861 Lakeside Dr
Blackfoot, ID 83221-1674
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Child Intellectual and/or Developmental Disabilities Respite Care Primary | 385HR2060X | None listed |
Child Intellectual and/or Developmental Disabilities Respite Care: A facility or distinct part of a facility that provides short term, residential care to children diagnosed with intellectual and/or developmental disabilities as respite for the regular caregivers.
About NPI 1083480404
Lucas Smith's National Provider Identifier is 1083480404, issued on Nov 27, 2023. The primary taxonomy on file is Child Intellectual and/or Developmental Disabilities Respite Care (385HR2060X), and the practice location is in Blackfoot, ID. The record was last updated on Nov 27, 2023.