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Southeastern Idaho Developmental Center, Inc .

Case Management Agency in Blackfoot, ID · enumerated 2008 · authorized official Jim Mccoy, Owner Director.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1568636959

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Registry record

Entity type Organization (Type 2)
Legal business name Southeastern Idaho Developmental Center, Inc .
Practice address 765 W Judicial St, Blackfoot, ID, 83221
Phone (208) 782-1301
Fax (208) 782-3627
Enumeration date Apr 16, 2008
Last updated in NPPES Apr 16, 2008

Taxonomy & classification

251B00000X Case Management Agency Agencies Primary

Authorized official

Name Jim Mccoy
Title Owner Director
Phone (208) 782-1301

Other identifiers

Identifier Type State Issuer
8068453 Medicaid ID -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2008-04-16. Verify at npiregistry.cms.hhs.gov.
Where is Southeastern Idaho Developmental Center, Inc . located?
The practice location on file with NPPES is in Blackfoot, ID.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2008-04-16.