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General NPI Number Information
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NPI Number | 1023939543
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Entity Type | Organization
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Legal Business Name | SUMMIT RECOVERY AND WELLNESS
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Dates
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Enumeration Date | 07/22/2026
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Last Update Date | 07/22/2026
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Provider Practice Location Address
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Address Line | 1935 CANYON CREST DR APT 105
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City | TWIN FALLS
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State | ID
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Zip | 83301-8009
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Country | US
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Telephone | 208-841-9622
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Fax |
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Provider Business Mailing Address
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Address Line | 1935 CANYON CREST DR APT 105
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City | TWIN FALLS
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State | ID
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Zip | 83301-8009
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Country | US
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Telephone | 208-841-9622
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Fax |
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Authorized Official
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Title or Position | DRUG AND ALCOHOL COUNSELOR
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Name | ERIN L DOMINGUEZ
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Credential | CADC
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Telephone | 208-841-9622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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