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General NPI Number Information
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NPI Number | 1346569647
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Entity Type | Organization
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Legal Business Name | VALLEYVIEW RECOVERY
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Dates
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Enumeration Date | 05/26/2010
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Last Update Date | 05/26/2010
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Provider Practice Location Address
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Address Line | 109 S. MILL ST.
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City | GRANGEVILLE
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State | ID
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Zip | 83530
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Country | US
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Telephone | 208-983-0898
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Fax | 208-983-0897
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Provider Business Mailing Address
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Address Line | 109 S MILL ST
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City | GRANGEVILLE
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State | ID
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Zip | 83530-2246
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Country | US
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Telephone | 208-983-0898
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Fax | 208-983-0897
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Authorized Official
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Title or Position | EX. DIRECTOR
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Name | MS. CHERYL M. MORTON
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Credential | MSW, CADC
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Telephone | 208-983-0898
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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 | 5900
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License Number State | ID
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