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General NPI Number Information
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NPI Number | 1558606962
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Entity Type | Organization
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Legal Business Name | TWIN FALLS COUNTY
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Dates
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Enumeration Date | 12/11/2012
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Last Update Date | 12/16/2020
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Provider Practice Location Address
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Address Line | 630 ADDISON AVE W STE 1000
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City | TWIN FALLS
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State | ID
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Zip | 83301-5853
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Country | US
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Telephone | 208-736-5048
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Fax | 208-735-2126
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Provider Business Mailing Address
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Address Line | PO BOX 126
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City | TWIN FALLS
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State | ID
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Zip | 83303-0126
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Country | US
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Telephone | 208-736-5048
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Fax | 208-735-2126
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. JACI EREN URIE
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Credential | LCSW
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Telephone | 208-736-5048
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #5
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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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