North Idaho Detox

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

NORTH IDAHO DETOX

Practice address

1654 E Velora Dr
Post Falls, ID 83854-4428

Phone

(208) 918-3835

NPI assigned

Feb 11, 2022

Last updated

Feb 11, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacob Siegberg, LPNNPI 1821445768

Title

Ceo

Phone

(208) 918-3835

Specialties & licenses 5

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacob Siegberg, LPN

  • Licensed Practical Nurse
  • Tigard, OR
  • NPI 1821445768
  NPD Authorized official

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1073267654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11933 N EMERALD DR",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838359424",
            "telephone_number": "208-918-3835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1654 E VELORA DR",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838544428",
            "telephone_number": "208-918-3835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH IDAHO DETOX",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-11",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "SIEGBERG",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-918-3835",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Keith Norling, DPT
• North Idaho Compounding Center LLC
• North Idaho Day Surgery LLC (Northwest Specialty Hospital)
• North Idaho Day Surgery LLC
• North Idaho Day Surgery LLC
• North Idaho Family Care
• North Idaho Family Physicians, LLC (After Hours Urgent Care Clinic)
• North Idaho Family Practice LLC
• North Idaho Immediate Care
• North Idaho Neurosurgery and Spine, PLLC

• Substance Abuse Rehabilitation Facility in Post Falls, ID
• Providers in Post Falls, ID by specialty
• Substance Abuse Rehabilitation Facility in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.