| Organization Name: | PEARL HEALTH CLINIC |
| NPI Number: | 1447426465 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THANA SINGARAJAH (PRESIDENT/OWNER) |
| Mailing Address: | 2705 E 17th St Ammon |
| State: | ID US |
| Postal Code: | 834066601 |
| Phone Number: | 2083467500 |
| Fax Number: | 2083467501 |
| NPI Enumeration Date: | 04/30/2008 |
| NPI Last Update Date: | 09/10/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |