Latah Recovery Community Center, Inc.

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Legal business name

LATAH RECOVERY COMMUNITY CENTER, INC.

Practice address

531 S Main
Moscow, ID 83843

Phone

(208) 883-1045

NPI assigned

Jul 29, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Darrell Eric Keim

Title

Executive Director

Phone

(208) 883-1045

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659052800000",
    "number": "1700512860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 S MAIN",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "83843",
            "telephone_number": "208-883-1045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 S MAIN",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "83843",
            "telephone_number": "208-883-1045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LATAH RECOVERY COMMUNITY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A",
        "authorized_official_last_name": "KEIM",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "208-883-1045",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Allard Lafortune, P.T.
• Matthew Lassen, PA-C
• Latah Community Health Pharmacy
• Latah Health Services, Inc.
• Latah Health Services, Inc.
• Anthony Leon Latno
• Jill Lynn Lawrence, LMT
• Sara Martin Lawrence, MD
• Sarah Kwate Lawrence, MD
• Maya Lawson Rivera

• Peer Specialist in Moscow, ID
• Providers in Moscow, ID by specialty
• Peer Specialist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.