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

South Park, Inc

Organization Case Management Agency · NPI 1437291044

South Park, Inc is a Case Management Agency in Pocatello, Idaho. Licensed in Idaho. Registered with an NPI since 2007.

Licensed in
ID
In the registry since
2007
Specialties on file
4
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

415 S Arthur Ave
Pocatello, ID 83204-3303
Phone: (208) 233-6833
Fax: (208) 233-6842
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Management Agency (primary) Taxonomy 251B00000X (ID)
Intellectual Disabilities Intermediate Care Facility Taxonomy 315P00000X · Licence 15 (ID)
Intellectual Disabilities Intermediate Care Facility Taxonomy 315P00000X · Licence 20 (ID)
Intellectual Disabilities Intermediate Care Facility Taxonomy 315P00000X · Licence 43 (ID)

Record details

NPI number1437291044
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Russell McCoy — Executive Director · (208) 233-6833
Other names Developmental Options
NPI enumeratedFebruary 12, 2007
Last updated in NPPESSeptember 11, 2025
Mailing address415 S Arthur Ave, Pocatello, ID 83204-3303

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