Provider Demographics
NPI:1851135040
Name:DOUBLE H TRAUMA AND ADDICTION RECOVERY CENTERS
Entity type:Organization
Organization Name:DOUBLE H TRAUMA AND ADDICTION RECOVERY CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:C
Authorized Official - Last Name:OWNES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-829-3160
Mailing Address - Street 1:845 W CENTER ST # L208
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83204-4205
Mailing Address - Country:US
Mailing Address - Phone:208-829-3160
Mailing Address - Fax:208-242-2302
Practice Address - Street 1:427 N MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83204-3016
Practice Address - Country:US
Practice Address - Phone:208-829-3160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-21
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty