Organization
ADVOCACY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARRETT SMITH (AUTHORIZED OFFICIAL/OWNER)
(208) 346-3926
Entity
Organization
Contact information
Practice address
2429 JAFER CT, IDAHO FALLS, ID 83404-5587
(208) 712-7077
(208) 384-9057
Mailing address
3270 E 17TH ST STE 261, AMMON, ID 83406-6758
(208) 712-7077
(208) 384-9057
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
03/08/2019
Last updated
07/08/2020
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