| Pro Active Advantage, Llc | |
|
215 University Dr Gooding ID 83330-6155 | |
| (208) 934-5880 | |
| (208) 934-5876 |
| Full Name | Pro Active Advantage, Llc |
|---|---|
| Speciality | Counselor |
| Location | 215 University Dr, Gooding, Idaho |
| Authorized Official Name and Position | Frank J. Knight (CEO) |
| Authorized Official Contact | 2089345880 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pro Active Advantage, Llc 215 University Dr Gooding ID 83330-6155 Ph: (208) 934-5880 | Pro Active Advantage, Llc 215 University Dr Gooding ID 83330-6155 Ph: (208) 934-5880 |
| NPI Number | 1366562316 |
|---|---|
| Provider Enumeration Date | 03/30/2007 |
| Last Update Date | 09/15/2021 |
| Certification Date | 09/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366562316 | NPI | - | NPPES |
| 8063821 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
Behavior Strategies Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 202 14th Ave E, Gooding, ID 83330 Phone: 208-308-8585 Fax: 208-934-4688 | |
Pro Active Advantage, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 215 University Dr, Gooding, ID 83330 Phone: 208-934-5880 Fax: 208-934-5876 | |
Pro Active Advantage, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 215 University Dr, Gooding, ID 83330 Phone: 208-934-5880 Fax: 208-934-5876 |