Pro Active Advantage, Llc in Gooding - Counselor
Pro Active Advantage, Llc - NPI 1366562316
Pro Active Advantage, Llc is a Counselor in Gooding, Idaho. Pro Active Advantage, Llc practices all healthcare services and medical treatments related to Counselor. The NPI Number for Pro Active Advantage, Llc is 1366562316. The last update date is 2021-09-15.
Pro Active Advantage, Llc's current location address is 215 University Dr, Gooding, Idaho. You can contact this provider via phone number 2089345880 and fax number 2089345876. The mailing address for Pro Active Advantage, Llc is 215 University Dr, Gooding, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Pro Active Advantage, Llc |
|---|---|
| Address | 215 University Dr, Gooding, Idaho |
| Phone Number | 2089345880 |
| Fax Number | 2089345876 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | Knight J. Frank |
| Telephone Number | 2089345880 |
NPI Number Detail
| NPI Number | 1366562316 |
|---|---|
| Provider Enumeration Date | 2007-03-30 |
| Last Updated Date | 2021-09-15 |
Provider Mailing Address Detail
| Address | 215 University Dr |
|---|---|
| City | Gooding |
| State | Idaho (ID) |
| Post Code | 833306155 |
| Phone Number | 2089345880 |
| Fax Number | 2089345876 |
Provider's Primary Taxonomy Detail
| Speciality | Counselor |
|---|---|
| Taxonomy | 101Y00000X |
|
Definition: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supe |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 8063821 | ID | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Pro Active Advantage, Llc by the Centers for Medicare & Medicaid Services?
The Pro Active Advantage, Llc has been issued the NPI (National Provider Identifier) 1366562316, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Pro Active Advantage, Llc is physically located?
The Pro Active Advantage, Llc is physically situated at the following address: 215 University Dr, Gooding, ID, 833306155.
What is Pro Active Advantage, Llc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Pro Active Advantage, Llc's area of specialization is Counselor, and the corresponding taxonomy code that categorizes this field of practice is 101Y00000X.
On what date was the 1366562316 assigned to Pro Active Advantage, Llc?
The Pro Active Advantage, Llc was issued its 1366562316 on 2007-03-30, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Pro Active Advantage, Llc, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Pro Active Advantage, Llc, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2021-09-15.