PHILLIPS RANCH, LLC
NPI 1881424224
Substance Abuse Rehabilitation Facility in Clark Fork, ID
About Phillips Ranch, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PHILLIPS RANCH, LLC (NPI 1881424224) is a healthcare organization registered as a substance abuse rehabilitation facility in Clark Fork, Idaho and active in the NPI registry since August 2024. The organization holds a CLIA Waiver certificate valid through May 12, 2027 and lists Alison Grace Aggen, Owner/clinical Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 13D2323732
Phillips Ranch LLC · Clark Fork, IDOther Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Phillips Ranch, LLC's NPI number?
The NPI number for Phillips Ranch, LLC is 1881424224. It was assigned to this organization in the NPPES registry on August 1, 2024.
Where is Phillips Ranch, LLC located?
Phillips Ranch, LLC is located at 3067 Mosquito Creek Rd, Clark Fork, ID 83811. The listed phone number is (720) 495-0550.
What is Phillips Ranch, LLC's specialty?
The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.
Does Phillips Ranch, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 13D2323732) is associated with this NPI, valid through May 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Phillips Ranch, LLC was last updated on January 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Phillips Ranch, Llc · NPI 1881424224
Substance Abuse Rehabilitation Facility organization in Clark Fork, Idaho. Organization record, active in the CMS NPPES registry since August 1, 2024.
## Identity
- **NPI:** 1881424224 (Entity type: Organization)
- **Enumerated:** August 1, 2024
- **Primary specialty:** Substance Abuse Rehabilitation Facility · taxonomy 324500000X
- **Organization subpart:** No
- **Authorized official:** Alison Aggen, OWNER/CLINICAL DIRECTOR
## Practice location
- **Address:** 3067 MOSQUITO CREEK RD, Clark Fork, ID 83811-9825
- **Phone:** (720) 495-0550
## Record status
- **NPPES last updated:** January 22, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1881424224) · Data from the CMS NPPES public registry.