NPIMap

Organization Active NPI

Abundant Wellnes Center

  • Community/Behavioral Health Agency
  • Post Falls, ID
National Provider Identifier
1093036600
Registry record updated Jun 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
LCSW28967 Issued in MT
Legal business name
ABUNDANT WELLNES CENTER
Practice address
1125 E Polston Ave
Suite a
Post Falls, ID 83854-6045
Phone
(208) 457-1540
Fax
(208) 457-1202
NPI assigned
Jun 17, 2010
Last updated
Jun 17, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2010

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

Authorized official

Name
Mrs. Tamera Leann Kinghorn, LCSW
Title
Therapist
Phone
(406) 560-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X LCSW28967 MT Primary

Addresses

Primary practice location

1125 E Polston Ave
Suite a
Post Falls, ID 83854-6045

Mailing address

1125 E Polston Ave
Suite a
Post Falls, ID 83854-6045
Phone (208) 457-1540

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276732800000",
    "number": "1093036600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 E POLSTON AVE",
            "address_2": "SUITE A",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838546045",
            "telephone_number": "208-457-1540",
            "fax_number": "208-457-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 E POLSTON AVE",
            "address_2": "SUITE A",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838546045",
            "telephone_number": "208-457-1540",
            "fax_number": "208-457-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT WELLNES CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-17",
        "last_updated": "2010-06-17",
        "status": "A",
        "authorized_official_last_name": "KINGHORN",
        "authorized_official_first_name": "TAMERA",
        "authorized_official_middle_name": "LEANN",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "406-560-8100",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MT",
            "license": "LCSW28967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; 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.