Provider Demographics
NPI:1689218018
Name:D6 TREATMENT
Entity Type:Organization
Organization Name:D6 TREATMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER / BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-242-9087
Mailing Address - Street 1:1001 N 7TH AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-5788
Mailing Address - Country:US
Mailing Address - Phone:208-242-9087
Mailing Address - Fax:208-242-9115
Practice Address - Street 1:1001 N 7TH AVE STE 260
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-5788
Practice Address - Country:US
Practice Address - Phone:208-242-9087
Practice Address - Fax:208-242-9115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-29
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID101YA0400XOtherTAXONOMY CODE