OrganizationActive
Club Inc
NPI 1871915694 · Mental Health Clinic/Center (Including Community Mental Health Center) · Idaho Falls, ID
Provider details
- NPI number
- 1871915694
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Kristee Criddle, Lnsw(208) 241-1377
- License
- LMSW-30202 (ID)
Specialties & taxonomies
- Mental Health Clinic/Center (Including Community Mental Health Center)Primary261QM0801XLicense LMSW-30202 (ID)
Ambulatory Health Care Facilities
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2001 S Woodruff
Suite 6
Idaho Falls, ID 83404
Phone: (208) 529-4673
Fax: (208) 529-4676
Street-level locationGet directions
Mailing address
2001 S Woodruff Ave
Idaho Falls, ID 83404-6374
Registry dates
- Enumerated
- 2014-01-14
- Last updated
- 2014-01-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.