THE PECKHAM FOUNDATION, INC – NPI #1205793619
Clinic/Center

THE PECKHAM FOUNDATION, INC is an AHC clinic located in PRIEST RIVER, ID. NPPES has assigned the NPI number 1205793619 to THE PECKHAM FOUNDATION, INC on January 07, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for THE PECKHAM FOUNDATION, INC below.

NPI Profile for
THE PECKHAM FOUNDATION, INC

NPI Number
1205793619
Enumeration Date

(about 5 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
THE PECKHAM FOUNDATION, INC
Primary location
50 MAIN ST STE 201
PRIEST RIVER, ID 83856-6758
Phone: (208) 448-4744 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
LON PECKHAM
CEO
Phone: (208) 448-4744
Updated
Certification Date
Jan 07, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.