Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Latino Stand Up Idaho LLC

Organization Child & Adolescent Psychiatry Physician · NPI 1043556608

Latino Stand Up Idaho LLC is a Child & Adolescent Psychiatry Physician in Idaho Falls, Idaho. Registered with an NPI since 2012.

In the registry since
2012
Specialties on file
8
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1680 Woodruff Park
Idaho Falls, ID 83401-3330
Phone: (208) 552-6373
Fax: (208) 552-2188
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Clinic/Center (Including Community Mental Health Center) (primary) Taxonomy 261QM0801X
Child & Adolescent Psychiatry Physician Taxonomy 2084P0804X
Case Management Agency Taxonomy 251B00000X
Community/Behavioral Health Agency Taxonomy 251S00000X
Adult Mental Health Clinic/Center Taxonomy 261QM0850X
Substance Use Disorder Rehabilitation Clinic/Center Taxonomy 261QR0405X
Medical Physician Assistant Taxonomy 363AM0700X
Clinical Nurse Specialist Taxonomy 364S00000X

Record details

NPI number1043556608
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Roger Horne — Owner · (910) 573-0861
Other names Latino Stand Up
NPI enumeratedDecember 28, 2012
Last updated in NPPESMay 23, 2013
Mailing address1680 Woodruff Park, Idaho Falls, ID 83401-3330

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