NPIMap

Organization Active NPI

Orchard Prairie Healthcare LLC

  • Home Health Agency
  • Coeur D Alene, ID
National Provider Identifier
1124903232
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ORCHARD PRAIRIE HEALTHCARE LLC
Practice address
1701 N 3Rd St
Coeur D Alene, ID 83814-3404
Phone
(509) 210-3741
NPI assigned
Aug 7, 2025
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Amber L Tueller
Title
Secretary
Phone
(208) 207-2726

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Facilities with the same owner 141

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251022000577 ID Part a Provider - Home Health Agency 9739626102 Practice locations: Coeur D Alene, ID

Home health agency certification: CCN 137306

Medicare enrollment files
Legal name
ORCHARD PRAIRIE HEALTHCARE LLC
Doing business as
MANITO HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 24, 2025
Last certification
Dec 5, 2025
Organization structure
LLCProprietary
Enrollment address
1701 N 3Rd St
Coeur D Alene, ID 83814-3404
HHA Branch

All disclosed owners & managing parties 8

Medicare enrollment files

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Cornerstone Healthcare Inc Organization, Eagle, ID Corporation, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Nov 1, 2025 100%
Brent Mills Individual Corporate OfficerTreasurer Mar 26, 2026
Brent Guerisoli Individual Corporate DirectorDirector Sep 26, 2024
The Pennant Group Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2025 100%
Marlee Ann Elmer Individual W-2 Managing EmployeeAd; Nov 1, 2025
John J Gochnour Individual Corporate OfficerManager/President Sep 26, 2024
Amber Tueller Individual Corporate OfficerSecretary Sep 26, 2024
Elliot McMillan Individual Corporate OfficerVice President Sep 26, 2024

National Provider Directory

National Provider Directory
Tax ID family
Manito Home Health3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1701 N 3Rd St
Coeur D Alene, ID 83814-3404

Mailing address

1701 N 3Rd St
Coeur D Alene, ID 83814-3404

Other names 1

NPPES NPI Registry
  • Manito Home Health Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 7, 2025.

{
    "created_epoch": "1754524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754524800000",
    "number": "1124903232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 N 3RD ST",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838143404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N 3RD ST",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838143404",
            "telephone_number": "509-210-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORCHARD PRAIRIE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-07",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-207-2726"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manito Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.