NPIMap

Organization Active NPI

Orchard Prairie Healthcare LLC

Doing business as Manito Home Health

  • Home Health Agency
  • Spokane, WA
National Provider Identifier
1770349474
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ORCHARD PRAIRIE HEALTHCARE LLC
Doing business as
Manito Home Health
Practice address
104 S Freya St Ste 109
Spokane, WA 99202-4890
Phone
(208) 401-1400
NPI assigned
Feb 21, 2024
Last updated
Jun 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

104 S Freya St Ste 109
Spokane, WA 99202-4890

Mailing address

104 S Freya St Ste 109
Spokane, WA 99202-4890
Phone (208) 401-1400

Other names 1

  • Manito Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240802000943 WA Part A Provider - Home Health Agency 9739626102 Practice locations: Spokane, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770349474. Details of each certification follow.

Home health agency certification: CCN 507310

Legal name
ORCHARD PRAIRIE HEALTHCARE LLC
Doing business as
MANITO HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 28, 2024
Last certification
Oct 17, 2024
Organization structure
LLCProprietary
Incorporated
Nov 22, 2021 in NV
Enrollment address
104 South Freya Street, Yellow Flag BLDG., Suite 109
Spokane, WA 99202

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Manito Home HealthCCN 507310 · All quality measures
Overall star rating
5 of 5
Ownership
-
Certified
Oct 28, 2024
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2308562Manito Home Health104 South Freya St, Yellow Flag BLDG, Ste 109, Spokane, WA 99202Certificate of waiverApr 4, 2028

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.

Locations

104 S Freya St
Ste 109
Spokane, WA 99202
Phone (509) 210-3741

Ownership & related parties

All disclosed owners & managing parties 8

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 22, 2021 100%
Brent Mills Individual Corporate OfficerTreasurer Mar 26, 2026
Brent Guerisoli Individual Corporate DirectorDirector and Sole Board Member Nov 22, 2021
The Pennant Group Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest Nov 22, 2021 100%
Marlee Ann Elmer Individual W-2 Managing EmployeeAd; May 1, 2025
John J Gochnour Individual Corporate OfficerPresident/LLC Manager Sep 26, 2024
Amber Tueller Individual Corporate OfficerCorporate Secretary Apr 10, 2024
Elliot McMillan Individual Corporate OfficerVice President Nov 22, 2021

Facilities with the same owner 141

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

View all 141

Practitioners & affiliated clinicians

Affiliated clinicians 10

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748995200000",
    "number": "1770349474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 S FREYA ST STE 109",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024890",
            "telephone_number": "208-401-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S FREYA ST STE 109",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024890",
            "telephone_number": "208-401-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORCHARD PRAIRIE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-21",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manito Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.