Touchmark at Meadow Lake Village Reitrement Resort, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

TOUCHMARK AT MEADOW LAKE VILLAGE REITREMENT RESORT, LLC

Doing business as

Touchmark at Meadow Lake Village Outpatient Clinic

Practice address

4037 E Clocktower LN
Meridian, ID 83642-8183

Phone

(208) 888-2277

Fax

(208) 888-9159

NPI assigned

Aug 4, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brian E. Pryor

Title

Executive Vice President

Phone

(503) 646-5186

Specialties & licenses 1

Addresses

Other names 1

• Touchmark at Meadow Lake Village Outpatient Clinic Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438646400000",
    "number": "1023494747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4037 E CLOCKTOWER LN",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428183",
            "telephone_number": "208-888-2277",
            "fax_number": "208-888-9159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4037 E CLOCKTOWER LN",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428183",
            "telephone_number": "208-888-2277",
            "fax_number": "208-888-9159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOUCHMARK AT MEADOW LAKE VILLAGE REITREMENT RESORT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-04",
        "last_updated": "2015-08-04",
        "status": "A",
        "authorized_official_last_name": "PRYOR",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "503-646-5186"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Touchmark at Meadow Lake Village Outpatient Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joana Torres-Fonseca
• Anthony Torres
• Jessica Jane Torres
• Total Health Solutions Inc
• Total Renal Care Inc (Treasure Valley Dialysis Center)
• Touchmark at Meadow Lake Village, LLC
• Touchmark of the Treasure Valley, LLC (Waterford Home Health)
• Ashley Metronus Trace, LCSW
• Trailblazer Integrative & Functional Nutrition, LLC
• Trailhead Medical Group LLC

• Physical Therapist in Meridian, ID
• Providers in Meridian, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.