NPIMap

Organization Active NPI

Kootenai Health, Inc.

Doing business as Adult Day Program

  • Adult Day Care Clinic/Center
  • Coeur d'Alene, ID
National Provider Identifier
1780981902
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
42 Issued in ID
Legal business name
KOOTENAI HEALTH, INC.
Doing business as
Adult Day Program
Practice address
2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone
(208) 666-2000
Fax
(208) 666-3963
NPI assigned
Feb 24, 2011
Last updated
Jan 5, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
KOOTENAI HEALTH, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Authorized official

Name
Jon Ness
Title
Ceo
Phone
(208) 625-5081

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 42 ID Primary

Addresses

Primary practice location

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051

Mailing address

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone (208) 666-2000

Other identifiers 1

IdentifierTypeStateIssuer
M8056472MedicaidID

Other names 1

  • Adult Day Program Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kootenai Health Inc14 organizations share this tax ID, including this one
Part of
Kootenai Health Inc

Other organizations with this tax ID 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1298505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704412800000",
    "number": "1780981902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 KOOTENAI HEALTH WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838146051",
            "telephone_number": "208-666-2000",
            "fax_number": "208-666-3963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 KOOTENAI HEALTH WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838146051",
            "telephone_number": "208-666-2000",
            "fax_number": "208-666-3963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOOTENAI HEALTH, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KOOTENAI HEALTH, INC.",
        "enumeration_date": "2011-02-24",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A",
        "authorized_official_last_name": "NESS",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-625-5081"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "ID",
            "license": "42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M8056472",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adult Day Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coeur d'Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.