Provider Demographics
NPI:1285486837
Name:CLEARCHECK RECOVERY LLC
Entity type:Organization
Organization Name:CLEARCHECK RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:MERLAINE
Authorized Official - Last Name:CORNIE
Authorized Official - Suffix:
Authorized Official - Credentials:ADC
Authorized Official - Phone:208-404-3636
Mailing Address - Street 1:479 POLK ST # 3B
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-4850
Mailing Address - Country:US
Mailing Address - Phone:208-404-3636
Mailing Address - Fax:
Practice Address - Street 1:479 POLK ST # 3B
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-4850
Practice Address - Country:US
Practice Address - Phone:208-404-3636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility