OrganizationAddiction Treatment Centers Of IdahoCommunity/Behavioral HealthAgenciesPractice Address5130 Treyden Dr, Ammon, ID 83406-8190(208) 534-8303PECOS EnrollmentBased on the most recent information from CMS, provider Addiction Treatment Centers Of Idaho does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1447641543Provider TypeOrganizationFull NameAddiction Treatment Centers Of IdahoSubpartNoEnumeration Date2/10/2015Last Updated2/10/2015Contact InformationPractice LocationPractice Address5130 Treyden Dr, Ammon, ID 83406-8190Phone(208) 534-8303FaxUnlisted FaxMailing LocationMailing Address5130 Treyden Dr, Ammon, ID 83406-8190Phone(208) 534-8303FaxUnlisted FaxAuthorized OfficialNameSmith, Matthew Frances (Office Manager)Phone(208) 534-8303Provider TaxonomiesCodeDescriptionLicenseCode251S00000XPrimaryDescriptionCommunity/Behavioral HealthAgenciesLicenseUnlisted Issuer