Pro Active Behavioral Health
LBN: Pro Active Advantage, Llc
Pro Active Behavioral Health is an health care organization with primary practice located at 562 Shoup Ave W , Twin Falls ID 83301-5029. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is the primary health care specialty.
Pro Active Advantage, Llc can be contacted via phone (208) 734-0407, or through Colwell, Lisa via phone (208) 734-0407.
Contact Information
Primary practice address
562 Shoup Ave W
Twin Falls ID 83301-5029
Phone: (208) 734-0407
Fax: (208) 734-3534
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | Idaho | |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | Idaho |
Profile Details
| NPI number | 1225139298 |
|---|---|
| LBN Legal business name | Pro Active Advantage, Llc |
| DBA Doing business as | Pro Active Behavioral Health |
| Authorized official | Colwell, Lisa |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 25th, 2006 |
| Last updated | Aug 22nd, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225139298 | NPPES |
| Idaho | MEDICAID | 807373500 |
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