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

South Park, Inc

Organization Intellectual Disabilities Intermediate Care Facility · NPI 1295954139

South Park, Inc is an Intellectual Disabilities Intermediate Care Facility in Pocatello, Idaho. Licensed in Idaho. Registered with an NPI since 2007.

Licensed in
ID
In the registry since
2007
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2369 Rulon Ave
Pocatello, ID 83201-1881
Phone: (208) 237-5538
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual Disabilities Intermediate Care Facility (primary) Taxonomy 315P00000X · Licence 00259790 (ID)

Record details

NPI number1295954139
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Russell McCoy — Executive Director · (208) 233-6833
Other names Rulon House Group Home
NPI enumeratedApril 25, 2007
Last updated in NPPESAugust 22, 2020
Mailing address415 S Arthur Ave, Pocatello, ID 83204-3303

Other providers in Pocatello