Organization
UPPER VALLEY COMMUNITY HEALTH SERVICES INC
Active
Other names
Grand Peaks Dental
Organization subpart
No
Provider details
NPI number
Authorized official
LORI K SESSIONS (CEO)
(208) 624-4100
Entity
Organization
Contact information
Practice address
325 E MAIN ST, SAINT ANTHONY, ID 83445-1546
(208) 356-4900
(208) 624-2265
Mailing address
PO BOX 18, SAINT ANTHONY, ID 83445-0018
(208) 356-4900
(208) 624-4112
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
02/17/2016
Last updated
05/02/2024
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