Active NPI
Moscow North of Cascadia, LLC
Doing business as Paradise Creek Health and Rehabilitation of Cascadia
- Skilled Nursing Facility
- Moscow, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- MOSCOW NORTH OF CASCADIA, LLC
- Doing business as
- Paradise Creek Health and Rehabilitation of Cascadia
- Practice address
- 640 N Eisenhower St
Moscow, ID 83843-9588 - Phone
- (208) 401-9500
- Fax
- (208) 314-0639
- NPI assigned
- Oct 25, 2022
- Last updated
- Jan 23, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Owen Hammond
- Title
- President
- Phone
- (208) 401-9600
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
640 N Eisenhower St
Moscow, ID 83843-9588
Mailing address
2205 E Riverside Dr Ste 100
Eagle, ID 83616-7621
Phone (208) 401-9600
Other names 1
- Paradise Creek Health and Rehabilitation of Cascadia
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230622002205 | ID | Part A Provider - Skilled Nursing Facility | 6608234638 | Practice locations: Moscow, ID |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1811614332. Details of each certification follow.
Skilled nursing facility certification: CCN 135067
- Legal name
- MOSCOW NORTH OF CASCADIA LLC
- Doing business as
- PARADISE CREEK HEALTH AND REHABILITATION OF CASCADIA
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 1, 1977
- Last certification
- Aug 29, 2024
- Beds
- 63
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Cascadia Healthcare
- Organization structure
- LLC
- Incorporated
- Oct 21, 2022 in DE
- Enrollment address
- 640 N Eisenhower St
Moscow, ID 83843-9588 - Nursing home name
- PARADISE CREEK HEALTH AND REHAB OF CASCADIA
- Affiliated entity
- CASCADIA HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Paradise Creek Health and Rehab of Cascadia
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jun 1, 1977
- Medicare certification status
- Active
- Certified beds
- 63
- Chain
- Cascadia Healthcare
- Penalties (3 years)
- 7
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 13D0665667 | Moscow North of Cascadia LLC | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 12
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Cascadia Services LLC | Operational/Managerial Control | Oct 21, 2022 | |
| Adp of the SNF | Oct 21, 2022 | ||
| Cascadia HC Group LLC | 5% Or Greater Indirect Ownership Interest | Jun 5, 2025 | 100% |
| Cascadia Healthcare LLC | 5% Or Greater Indirect Ownership Interest | Oct 21, 2022 | 100% |
| Stephen J Laforte | 5% Or Greater Indirect Ownership Interest | Jun 5, 2025 | 33.33% |
| Owen C Hammond | 5% Or Greater Indirect Ownership Interest | May 1, 2023 | 33.34% |
| Operational/Managerial Control | May 1, 2023 | ||
| Moscow 640 Realty, LLC | 5% Or Greater Security Interest | Jun 5, 2025 | 100% |
| Adp of the SNF | Jun 5, 2025 | ||
| White Oak Healthcare Finance LLC | 5% Or Greater Security Interest | Aug 11, 2022 | 100% |
| Cascadia Holdco LLC | 5% Or Greater Indirect Ownership Interest | Jun 5, 2025 | 100% |
| Robert Spady | Operational/Managerial Control | May 1, 2023 | |
| Adp of the SNF | Feb 26, 2025 | ||
| Cascadia Idaho Operations LLC | 5% Or Greater Direct Ownership Interest | May 1, 2023 | 100% |
| Timothy Nelson | 5% Or Greater Indirect Ownership Interest | Jun 5, 2025 | 33.33% |
| Operational/Managerial Control | Jun 5, 2025 | ||
| Daniel Bong | Operational/Managerial Control | Feb 20, 2026 | |
| Adp of the SNF | Apr 10, 2026 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Moscow, ID
- NPI 1053329490
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 46
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba The Cove of Cascadia
- Skilled Nursing Facility
- Bellevue, ID
- NPI 1861946436
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Idaho Operations LLC, Cascadia Services LLC
-
dba Cascadia of Boise
- Skilled Nursing Facility
- Boise, ID
- NPI 1295249241
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Idaho Operations LLC, Cascadia Services LLC
-
dba Arbor Valley of Cascadia
- Skilled Nursing Facility
- Boise, ID
- NPI 1063966638
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Idaho Operations LLC, Cascadia Services LLC
-
- Skilled Nursing Facility
- Eagle, ID
- NPI 1447960307
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Services LLC
-
dba Caldwell Care of Cascadia
- Skilled Nursing Facility
- Caldwell, ID
- NPI 1467978460
Cascadia Services LLC
-
dba Wellspring Health & Rehabilitation of Cascadia
- Skilled Nursing Facility
- Nampa, ID
- NPI 1699208280
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Idaho Operations LLC, Cascadia Services LLC
-
- Skilled Nursing Facility
- Caldwell, ID
- NPI 1770009680
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Idaho Operations LLC, Cascadia Services LLC
-
- Skilled Nursing Facility
- Orofino, ID
- NPI 1760925572
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Idaho Operations LLC, Cascadia Services LLC
-
- Skilled Nursing Facility
- Coeur d'Alene, ID
- NPI 1487197299
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Idaho Operations LLC, Cascadia Services LLC
-
dba Cherry Ridge of Cascadia
- Skilled Nursing Facility
- Emmett, ID
- NPI 1497388003
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Idaho Operations LLC, Cascadia Services LLC
-
- Skilled Nursing Facility
- Grangeville, ID
- NPI 1740942622
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Idaho Operations LLC, Cascadia Services LLC
-
- Skilled Nursing Facility
- Idaho Falls, ID
- NPI 1972220473
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Idaho Operations LLC, Cascadia Services LLC
Practitioners & affiliated clinicians
Affiliated clinicians 5
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": "1666656000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1705968000000",
"number": "1811614332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2205 E RIVERSIDE DR STE 100",
"city": "EAGLE",
"state": "ID",
"postal_code": "836167621",
"telephone_number": "208-401-9600",
"fax_number": "208-314-0639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 N EISENHOWER ST",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838439588",
"telephone_number": "208-401-9500",
"fax_number": "208-314-0639"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MOSCOW NORTH OF CASCADIA, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-10-25",
"last_updated": "2024-01-23",
"certification_date": "2024-01-23",
"status": "A",
"authorized_official_last_name": "HAMMOND",
"authorized_official_first_name": "OWEN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "208-401-9600"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Paradise Creek Health and Rehabilitation of Cascadia",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Moscow, ID
- Moscow Chiropractic Clinic
- Moscow Family Eye Care Inc. (Moscow Family Eye Care)
- Moscow Health and Wellness Center, P.L.L.C.
- Moscow Medical, P.a.
- Moscow Mountain Anesthesia, PLLC
- Moscow of Cascadia, LLC (Aspen Park of Cascadia)
- Moscow of Olympus LLC
- Moscow Physical Therapy, LLC (Peak Physical Therapy)
- Motherwise Midwifery Service, LLC
- Ruth Tadios Munie, PHARMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.