Coeur D'Alene Partners, LLC Dba Creekside Inn Assisted Living Alz Comm

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

RC-954 Issued in ID

Legal business name

COEUR D'ALENE PARTNERS, LLC DBA CREEKSIDE INN ASSISTED LIVING ALZ COMM

Practice address

240 E Kathleen Ave
Coeur D Alene, ID 83815-9812

Phone

(208) 665-2444

NPI assigned

Nov 18, 2011

Last updated

Dec 14, 2011By 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

Mr. Emmett Aaron Koelsch

Title

Manager

Phone

(360) 867-1900

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

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

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323820800000",
    "number": "1649547670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MARKET ST NE STE 200",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985011008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 E KATHLEEN AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838159812",
            "telephone_number": "208-665-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COEUR D'ALENE PARTNERS, LLC DBA CREEKSIDE INN ASSISTED LIVING ALZ COMM",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-18",
        "last_updated": "2011-12-14",
        "status": "A",
        "authorized_official_last_name": "KOELSCH",
        "authorized_official_first_name": "EMMETT",
        "authorized_official_middle_name": "AARON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "360-867-1900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "ID",
            "license": "RC-954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alzheimer Center (Dementia Center) in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Alzheimer Center (Dementia Center) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.