Lucas Smith
Lucas Smith is a Child Intellectual and/or Developmental Disabilities Respite Care in Blackfoot, Idaho. Practices as a sole proprietor. Registered with an NPI since 2023.
- In the registry since
- 2023
Practice location Address checks out
861 Lakeside DrBlackfoot, ID 83221-1674
Phone: (208) 360-7355
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Child Intellectual and/or Developmental Disabilities Respite Care (primary) | Taxonomy 385HR2060X |
|---|
Record details
| NPI number | 1083480404 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | November 27, 2023 |
| Last updated in NPPES | November 27, 2023 |
| Certification date | November 27, 2023 |
| Mailing address | 861 Lakeside Dr, Blackfoot, ID 83221-1674 |