NPI age
1 years
Enumerated 2024-08-01
● Active Type 2 · Organization
Phillips Ranch, Llc
Phillips Ranch, Llc is 1 of 36 substance abuse rehabilitation facility organizations in Idaho.
Primary specialty
Substance Abuse Rehabilitation Facility
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Aggen
Owner/clinical Director
Last NPPES update
2025-01-22
Source: monthly bulk 2026-05
How this organization compares
Across 36 active substance abuse rehabilitation facility providers in Idaho.
NPI age
1 years
↓ 7 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2024 → 2026
2024-08Enumerated in NPPES
2024
2026
Where they practice
Primary practice location
3067 Mosquito Creek Rd
Clark Fork, ID 838119825
Mailing address
640 Champs Rd
Bonners Ferry, ID 838056219
Authorized official
Alison Grace Aggen, LPCC
Owner/clinical Director
📞 7204950550
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Mary Cook Case Manager/Care Coordinator NPI 1760270326
Specialties
-
Substance Abuse Rehabilitation Facility PrimaryA facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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