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

Lucas Smith

Individual provider Child Intellectual and/or Developmental Disabilities Respite Care · NPI 1083480404

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 Dr
Blackfoot, ID 83221-1674
Phone: (208) 360-7355
Show map & directions

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 number1083480404
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 27, 2023
Last updated in NPPESNovember 27, 2023
Certification dateNovember 27, 2023
Mailing address861 Lakeside Dr, Blackfoot, ID 83221-1674