Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
PRO ACTIVE ADVANTAGE, LLC
Active
Organization
PRO ACTIVE ADVANTAGE, LLC
Active
Other names
Pro Active Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK J. KNIGHT (CEO)
(208) 934-5880
Entity
Organization
Contact information
Practice address
264 MAIN AVE S, TWIN FALLS, ID 83301-6232
(208) 772-4935
(208) 734-3534
Mailing address
215 UNIVERSITY DR, GOODING, ID 83330-6155
(208) 934-5880
(208) 934-5876
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8062720
—
ID
Enumeration date
04/04/2007
Last updated
09/15/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up