Organization · NPI-2

Advocacy Center

Clinic/Center, Adult Mental Health · Idaho Falls, ID

NPI number1760940639
StatusActive
Last updated in NPPESJul 8, 2020

Details

NPI
1760940639
Entity type
Organization (NPI-2)
Legal business name
Advocacy Center
Organization subpart
No
Enumeration date
Mar 8, 2019
Certification date
Jul 8, 2020
Last updated
Jul 8, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0850X Clinic/Center, Adult Mental Health––Yes
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––
261QM0855X Clinic/Center, Adolescent and Children Mental Health––

Practice location

2429 Jafer Ct
Idaho Falls, ID 83404-5587

Phone 208-712-7077 · Fax 208-384-9057

Mailing address

3270 E 17th St Ste 261
Ammon, ID 83406-6758

Phone 208-712-7077 · Fax 208-384-9057

Authorized official

Garrett Smith
Authorized Official/Owner
2083463926

Is something wrong?

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