Organization
PINNACLE HEALTH SYSTEMS
Active
Organization
PINNACLE HEALTH SYSTEMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONEVAN B NEIDER LCSW (OWNER)
(208) 552-0920
Entity
Organization
Contact information
Practice address
1522 ELK CREEK DRIVE, IDAHO FALLS, ID 83404
(208) 552-0920
(208) 529-2564
Mailing address
1522 ELK CREEK DRIVE, IDAHO FALLS, ID 83404
(208) 552-0920
(208) 529-2564
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807134000
—
ID
Enumeration date
06/15/2006
Last updated
05/06/2009
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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