GRAND TETON SERVICE GROUP
NPI: 1578724910
· IDAHO FALLS, ID 83402
· Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
· NPI assigned 06/18/2008
$104K
Total Medicaid Paid
Provider Details
| Authorized Official | BOWMAN, LISA (PROGRAM DIRECTOR) |
| NPI Enumeration Date | 06/18/2008 |
Related Entities
Other providers sharing the same authorized official: BOWMAN, LISA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
474 |
$16K |
| 2019 |
458 |
$27K |
| 2020 |
895 |
$34K |
| 2021 |
738 |
$27K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1001 |
Nursing assessment / evaluation |
2,565 |
1,404 |
$104K |