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General NPI Number Information
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NPI Number | 1851135040
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Entity Type | Organization
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Legal Business Name | DOUBLE H TRAUMA AND ADDICTION RECOVERY CENTERS
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Dates
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Enumeration Date | 06/21/2024
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 845 W CENTER ST # L208
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City | POCATELLO
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State | ID
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Zip | 83204-4205
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Country | US
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Telephone | 208-829-3160
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Fax | 208-242-2302
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Provider Business Mailing Address
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Address Line | 845 W CENTER ST # L208
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City | POCATELLO
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State | ID
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Zip | 83204-4205
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Country | US
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Telephone | 208-829-3160
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Fax | 208-242-2302
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Authorized Official
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Title or Position | OWNER
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Name | HOLLY C MCLAIN
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Credential | LCSW
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Telephone | 208-829-3160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 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 |
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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