Provider Demographics
NPI:1376214973
Name:WAYPOINT DEVELOPMENTAL CENTER LLC
Entity Type:Organization
Organization Name:WAYPOINT DEVELOPMENTAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DS
Authorized Official - Prefix:
Authorized Official - First Name:GWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:EARLS
Authorized Official - Suffix:
Authorized Official - Credentials:BS, DS, QIDP, IBI
Authorized Official - Phone:208-949-5596
Mailing Address - Street 1:1812 N MIDLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-1747
Mailing Address - Country:US
Mailing Address - Phone:208-949-5596
Mailing Address - Fax:
Practice Address - Street 1:1812 N MIDLAND BLVD
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-1747
Practice Address - Country:US
Practice Address - Phone:208-949-5596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services