OrganizationActive
Brandy M Bates, LLC
NPI 1184573032 · Medical Specialty Clinic/Center · Pocatello, ID
Provider details
- NPI number
- 1184573032
- Entity type
- Organization
- Primary specialty
- Medical Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Brandy Bates, Owner/Provider(208) 851-9151
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
2434 S Fairway Dr
Pocatello, ID 83201-2372
Phone: (208) 851-9151
Fax: (208) 977-0029
Approximate (ZIP-level) locationGet directions
Mailing address
2434 S Fairway Dr
Pocatello, ID 83201-2372
Other names (DBA / former)
- Doing business as
- Haven Complete Wellness Services
Registry dates
- Enumerated
- 2026-01-23
- Last updated
- 2026-01-23
- Certified
- 2026-01-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.