Throne of Grace, Llc.
NPI #1104173467 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1104173467
- Entity Type
- Organization
- Organization Name
- Throne of Grace, Llc.
- Primary Specialty
- Clinic/Center - Rehabilitation, Substance Use Disorder
- Enumeration Date
- Aug 6, 2012
- Last Updated
- Dec 26, 2012
Practice Location
- Address
- 1165 S UTAH AVE
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83402-3321
- Phone
- (208) 522-6155
Authorized Official
- Name
- DAVID W PINEGAR
- Title
- EXECUTIVE DIRECTOR
- Phone
- (208) 522-6155
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder |
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