Portneuf Valley Family Center

LBN: Portneuf Valley Family Center
Portneuf Valley Family Center is an health care organization with primary practice located at 444 Hospital Way Ste 477 , Pocatello ID 83201-2744. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as the primary health care specialty. Portneuf Valley Family Center can be contacted via phone (208) 233-7832, or through De Wall, Robert Andrew via phone (208) 233-7832.

Contact Information

Primary practice address
444 Hospital Way Ste 477 Pocatello ID 83201-2744
Phone: (208) 233-7832
Fax: (208) 233-7835
Website:
Map and Directions
Authorized official contact:
Name: De Wall, Robert Andrew
Phone: (208) 233-7832

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X

Profile Details

NPI number 1174629976
LBN Legal business name Portneuf Valley Family Center
DBA Doing business as
Authorized official De Wall, Robert Andrew
Entity Organization
Organization subpart 1 No
Enumeration date Sep 16th, 2006
Last updated Oct 22nd, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174629976 NPPES
Idaho MEDICAID 807338300
Idaho MEDICAID 807319500

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