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General NPI Number Information
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NPI Number | 1285486837
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Entity Type | Organization
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Legal Business Name | CLEARCHECK RECOVERY LLC
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Dates
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Enumeration Date | 04/04/2024
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 598 ADDISON AVE W
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City | TWIN FALLS
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State | ID
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Zip | 83301-5039
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Country | US
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Telephone | 208-404-3636
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Fax | 208-561-6495
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Provider Business Mailing Address
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Address Line | 598 ADDISON AVE W
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City | TWIN FALLS
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State | ID
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Zip | 83301-5039
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Country | US
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Telephone | 208-404-3636
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Fax | 208-561-6495
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Authorized Official
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Title or Position | DIRECTOR
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Name | JENNIFER MERLAINE CORNIE
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Credential | CADC
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Telephone | 208-404-3636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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