Place of Food

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

PLACE OF FOOD

Practice address

1131 Cole St
Kimberly, ID 83341-5138

Phone

(208) 490-2778

NPI assigned

May 24, 2018

Organization subpart

No

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

Authorized official

Name

Katie Wyatt

Title

Owner/Ceo

Phone

(208) 490-2778

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527120000000",
    "number": "1477044543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 COLE ST",
            "city": "KIMBERLY",
            "state": "ID",
            "postal_code": "833415138",
            "telephone_number": "208-490-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 COLE ST",
            "city": "KIMBERLY",
            "state": "ID",
            "postal_code": "833415138",
            "telephone_number": "208-490-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLACE OF FOOD",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-24",
        "last_updated": "2018-05-24",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "208-490-2778"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ariel Fay Newman, LPC
• Northstar in Home Support Services
• Northwest Bec Corp
• Oak Creek Rehabilitation Center of Kimberly LLC
• Amanda Lachelle Pereira
• Sara Raeli Prescott, M.S., CF-SLP
• Jysika Lynn Irene Ramirez
• Brent Randall
• Susan Kathryn Rauma, SLP
• Christine Rene Reeds, OT/L

• All providers in Kimberly, ID
• Health Service Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; 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.