Lifespan Family Practice Mental Health Clinic

LBN: Tw Mcknight Enterprises
Lifespan Family Practice Mental Health Clinic is an health care organization with primary practice located at 550 Polk St Suite A, Twin Falls ID 83301-3916. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as the primary health care specialty. Tw Mcknight Enterprises can be contacted via phone (208) 736-7090, or through Mcknight, Wendy L via phone (208) 736-7090.

Contact Information

Primary practice address
550 Polk St Suite A Twin Falls ID 83301-3916
Phone: (208) 736-7090
Fax: (208) 736-7089
Website:
Map and Directions
Authorized official contact:
Name: Mcknight, Wendy L
Phone: (208) 736-7090

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X

Profile Details

NPI number 1821388505
LBN Legal business name Tw Mcknight Enterprises
DBA Doing business as Lifespan Family Practice Mental Health Clinic
Authorized official Mcknight, Wendy L
Entity Organization
Organization subpart 1 No
Enumeration date Apr 14th, 2011
Last updated Apr 14th, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821388505 NPPES
Idaho MEDICAID PENDING

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