OrganizationActive
Throne of Grace, LLC.
NPI 1104173467 · Substance Use Disorder Rehabilitation Clinic/Center · Idaho Falls, ID
Provider details
- NPI number
- 1104173467
- Entity type
- Organization
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- David Pinegar, Executive Director
Practice location
1165 S Utah Ave
Idaho Falls, ID 83402-3321
Phone: (208) 522-6155
Fax: (208) 522-6156
Mailing address
1165 S Utah Ave
Idaho Falls, ID 83402-3321
Registry dates
- Enumerated
- 2012-08-06
- Last updated
- 2012-12-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.