Portneuf Valley Family Center
NPI 1174629976ActiveOrganization· Counselor, Professional· Pocatello, ID
Counselor, Professional in Pocatello, Idaho, registered in NPPES in September 2006. The authorized official on file is Robert De Wall, Owner/Administrator. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1174629976 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 16, 2006 |
| Last updated in NPPES | Jun 27, 2025 |
| Certified by provider | Jun 27, 2025 |
Specialties and licenses
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (ID) |
|---|
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