Throne of Grace, Llc.

NPI #1063820629 in Pocatello, Idaho

Provider Information

NPI Number
1063820629
Entity Type
Organization
Organization Name
Throne of Grace, Llc.
Primary Specialty
Clinic/Center - Rehabilitation, Substance Use Disorder
Enumeration Date
Jul 28, 2014
Last Updated
Jul 28, 2014

Practice Location

Address
4460 CENTRAL WAY
State
Idaho
ZIP Code
83202-5095
Phone
(208) 522-6155

Authorized Official

Name
MR. DAVID PINEGAR
Title
EXECUTIVE DIRECTOR
Phone
(208) 522-6155

Specialties & Taxonomy Codes

Specialty
Counselor - Addiction (Substance Use Disorder)Addiction (Substance Use Disorder)
Counselor - Mental HealthMental Health
Clinic/Center - Rehabilitation, Substance Use DisorderRehabilitation, Substance Use Disorder

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