NPI 1063820629

Throne of Grace, LLC.

Organisation Substance Use Disorder Rehabilitation Clinic/Center Pocatello, ID

Practice location

Address: 4460 Central Way, Pocatello, ID 83202-5095
Phone: (208) 522-6155
Fax: (208) 522-6156
Mailing address: 1165 S Utah Ave, Idaho Falls, ID 83402-3321

Authorised official

Name: David Pinegar
Title: Executive Director
Phone: (208) 522-6155

Registered specialties (3)

Substance Use Disorder Rehabilitation Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QR0405X

Other Clinic/Center providers in Idaho →

Addiction (Substance Use Disorder) Counselor

Behavioral Health & Social Service Providers Taxonomy 101YA0400X

Other Counselor providers in Idaho →

Mental Health Counselor

Behavioral Health & Social Service Providers Taxonomy 101YM0800X

Registry record

NPI: 1063820629
Entity type: Organization
NPI issued: 28 Jul 2014
Record last updated: 28 Jul 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.