National Provider Identifier Database

THRONE OF GRACE LLC
Rehabilitation, Substance Use Disorder


Contact Information

THRONE OF GRACE, LLC.
4460 CENTRAL WAY
POCATELLO, ID83202-5095
Phone: 208-522-6155
Fax: 208-522-6156
Website:
Specialty Taxonomy Code
* Rehabilitation, Substance Use Disorder 261QR0405X
Addiction (Substance Use Disorder) 101YA0400X
Mental Health 101YM0800X

* Indicates primary specialty

NPI Profile & details for THRONE OF GRACE, LLC.

NPI Number 1063820629
Legal business name
LBN
THRONE OF GRACE, LLC.
Authorized official DAVID PINEGAR - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 07/28/2014
Last updated 07/28/2014 - About 12 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for THRONE OF GRACE, LLC.

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