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
215 UNIVERSITY DR, GOODING, ID 83330-6155
(208) 934-5880
(208) 934-5876
Mailing address
562 SHOUP AVE W, TWIN FALLS, ID 83301-5029
(208) 734-0407
(208) 734-3534
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8067725
—
ID
Enumeration date
04/02/2007
Last updated
09/15/2021
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