| Community Council Of Idaho, Inc | |
|
2100 Alan St Idaho Falls ID 83404-5801 | |
| (208) 528-7655 | |
| (208) 524-9390 |
| Full Name | Community Council Of Idaho, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2100 Alan St, Idaho Falls, Idaho |
| Authorized Official Name and Position | Arnold Cantu (CLINIC ADMINISTRATOR) |
| Authorized Official Contact | 2085287655 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Council Of Idaho, Inc 2100 Alan St Idaho Falls ID 83404-5801 Ph: (208) 528-7655 | Community Council Of Idaho, Inc 2100 Alan St Idaho Falls ID 83404-5801 Ph: (208) 528-7655 |
| NPI Number | 1710925250 |
|---|---|
| Provider Enumeration Date | 06/04/2006 |
| Last Update Date | 11/13/2023 |
| Medicare PECOS PAC ID | 6204877467 |
|---|---|
| Medicare Enrollment ID | O20050627001149 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710925250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Gene K Hodges |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316055320 PECOS PAC ID: 0648360727 Enrollment ID: I20071212000722 |
| Provider Name | Ronald K Sebreros |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386901627 PECOS PAC ID: 2062738792 Enrollment ID: I20150224000703 |
| Provider Name | Joshua Stringam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164860078 PECOS PAC ID: 3971731332 Enrollment ID: I20160725002276 |
| Provider Name | Eric F Bennett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083155337 PECOS PAC ID: 2860743564 Enrollment ID: I20201216003069 |
| Provider Name | William J May |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1801037551 PECOS PAC ID: 6002257789 Enrollment ID: I20240513000951 |
| Provider Name | Noemi Rivas Briones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619657020 PECOS PAC ID: 1456893619 Enrollment ID: I20240604001826 |
Shane G Machen, Do Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1995 E 17th St Ste A, Idaho Falls, ID 83404 Phone: 208-522-7666 Fax: 208-524-2821 | |
Physician Skin Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 730 S Woodruff Ave, Idaho Falls, ID 83401 Phone: 208-542-9111 | |
Family First Medical Center, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3614 Washington Pkwy, Idaho Falls, ID 83404 Phone: 208-552-7700 Fax: 208-552-1783 | |
Imed Hrs Idaho Falls Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 801-507-3500 | |
Neville Spinal Balance Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2145 West Broadway Street, Idaho Falls, ID 83402 Phone: 208-522-3130 | |
R.k. Arbon, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2860 Channing Way, Suite 116, Idaho Falls, ID 83404 Phone: 208-529-0575 Fax: 208-528-0223 | |
Idaho Falls Family & Sports Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3360 Washington Pkwy, Suite 1, Idaho Falls, ID 83404 Phone: 208-524-3416 Fax: 208-524-3138 |