Pro Active Behavioral Health

LBN: Pro Active Advantage, Llc
Pro Active Behavioral Health is an health care organization with primary practice located at 1369 E 16Th St Ste 2 , Burley ID 83318-2008. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Rehabilitation, which is considered as the primary health care specialty. Pro Active Advantage, Llc can be contacted via phone (208) 878-3423, or through Knight, Frank J via phone (208) 934-5880.

Contact Information

Primary practice address
1369 E 16Th St Ste 2 Burley ID 83318-2008
Phone: (208) 878-3423
Fax: (208) 878-3424
Website:
Map and Directions
Authorized official contact:
Name: Knight, Frank J
Phone: (208) 934-5880

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Rehabilitation 103TR0400X

Profile Details

NPI number 1124148176
LBN Legal business name Pro Active Advantage, Llc
DBA Doing business as Pro Active Behavioral Health
Authorized official Knight, Frank J
Entity Organization
Organization subpart 1 No
Enumeration date Mar 30th, 2007
Last updated Sep 15th, 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 1124148176 NPPES
Idaho MEDICAID 8073698

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