Healthcare Provider Details

I. General information

NPI: 1285486837
Provider Name (Legal Business Name): CLEARCHECK RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2024
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

598 ADDISON AVE W
TWIN FALLS ID
83301-5039
US

IV. Provider business mailing address

598 ADDISON AVE W
TWIN FALLS ID
83301-5039
US

V. Phone/Fax

Practice location:
  • Phone: 208-404-3636
  • Fax: 208-561-6495
Mailing address:
  • Phone: 208-404-3636
  • Fax: 208-561-6495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER MERLAINE CORNIE
Title or Position: DIRECTOR
Credential: CADC
Phone: 208-404-3636