# TETON VALLEY HEALTHCARE, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TETON VALLEY HEALTHCARE, INC
- **Other names:** Cache Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1417405606
- **Legal business name:** TETON VALLEY HEALTHCARE, INC
- **Authorized official:** LAURA C PIQUET (DIRECTOR OF COMPLIANCE)
- **Authorized official phone:** (208) 354-6302

## Contact information

- **Practice address:** 30 E LITTLE AVE, DRIGGS, ID 83422-5138
- **Practice address phone:** (208) 354-6302
- **Practice address fax:** (208) 354-3158
- **Mailing address:** 120 E HOWARD ST, DRIGGS, ID 83422-5112
- **Mailing address phone:** (208) 354-6302
- **Mailing address fax:** (208) 354-3158

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 31 | ID | Yes |
| 363AM0700X | Medical Physician Assistant | 31 | ID | — |
| 363LF0000X | Family Nurse Practitioner | 31 | ID | — |

## Other

- **Enumeration date:** 09/15/2016
- **Last updated:** 09/15/2016