Portneuf Valley Family Center in Pocatello - Counselor
Portneuf Valley Family Center - NPI 1174629976
Portneuf Valley Family Center is a Counselor in Pocatello, Idaho. Portneuf Valley Family Center practices all healthcare services and medical treatments related to Counselor. The NPI Number for Portneuf Valley Family Center is 1174629976. The last update date is 2021-10-22.
Portneuf Valley Family Center's current location address is Po Box 4908, Pocatello, Idaho. You can contact this provider via phone number 2082361600 and fax number 8449460909. The mailing address for Portneuf Valley Family Center is Po Box 4908, Pocatello, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Portneuf Valley Family Center |
|---|---|
| Address | Po Box 4908, Pocatello, Idaho |
| Phone Number | 2082361600 |
| Fax Number | 8449460909 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER/ADMI |
|---|---|
| Authorized Official Name | De Wall Andrew Robert |
| Telephone Number | 2082337832 |
NPI Number Detail
| NPI Number | 1174629976 |
|---|---|
| Provider Enumeration Date | 2006-09-16 |
| Last Updated Date | 2021-10-22 |
Provider Mailing Address Detail
| Address | Po Box 4908 |
|---|---|
| City | Pocatello |
| State | Idaho (ID) |
| Post Code | 832054908 |
| Phone Number | 2082361600 |
| Fax Number | 8449460909 |
Provider's Primary Taxonomy Detail
| Speciality | Counselor |
|---|---|
| Taxonomy | 101Y00000X |
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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 |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 807338300 | ID | -- | |
| 807319500 | ID | -- |
Post Comment/ Review Below
What is Portneuf Valley Family Center's specialized field of practice, and what is the corresponding taxonomy classification code?
The Portneuf Valley Family Center's area of specialization is Counselor, and the corresponding taxonomy code that categorizes this field of practice is 101Y00000X.
What is Portneuf Valley Family Center's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Portneuf Valley Family Center is Counselor, and the corresponding taxonomy classification code for this specialized field is 101Y00000X.
On what date was the 1174629976 assigned to Portneuf Valley Family Center?
The Portneuf Valley Family Center was issued its 1174629976 on 2006-09-16, 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 Portneuf Valley Family Center most recently updated?
The details pertaining to the Portneuf Valley Family Center, including its address, specialty, and other relevant information, were last refreshed on 2021-10-22.
As of what date was the information pertaining to Portneuf Valley Family Center, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Portneuf Valley Family Center, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2021-10-22.