KELLEY KIDS RANCH, LLC (NPI# 1134774680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134774680 |
| Entity Type | Organization |
| Organization Name | KELLEY KIDS RANCH, LLC |
| Practice Address |
602 13th St Lewiston ID 83501-2586 |
| Mailing Address |
1607 17th Ave Lewiston ID 83501-4001 |
| Practice Telephone | 2086757350 |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2019-08-01 |
| Authorized Official Name | AMY T KELLEY (OWNER) |
| Authorized Official Telephone | 2086757350 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
602 13TH ST |
| City | LEWISTON |
| State | ID |
| Zip Code | 83501-2586 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801428917 | Northwest Children's Home | Social Worker | 602 13th St, Lewiston, ID 83501-2586 | 2020-02-06 |
| 1760014872 | Northwest Children's Home | Clinic/Center | 602 13th St, Lewiston, ID 83501-2586 | 2020-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679193759 | Jacqueline M Aldrich | Behavior Technician | 3407 12th Street C, 3407 12th Street C, Lewiston, ID 83501 | 2020-04-20 |
| 1295228054 | Provident Foundation - Wedgewood Terrace LLC | Alzheimer Center (Dementia Center) | 2114 Vineyard Avenue, Lewiston, ID 83501 | 2018-06-07 |
| 1164945325 | Xiaofei Liu | Massage Therapist | 234 Thain Rd, Lewiston, ID 83501 | 2017-07-19 |
| 1467909879 | Sharon Thulon | Registered Nurse | 1118 F Street, Lewiston, ID 83501 | 2016-09-01 |
| 1821459496 | Gem State Endoscopy | Clinic/Center | 3709 14th Street, Lewiston, ID 83501 | 2016-03-10 |
| 1508264995 | Gary L. Grogan | Psychologist | 633 Main Street, B#1, Lewiston, ID 83501 | 2014-12-17 |
| 1003189366 | John Joseph Johnson | Dentist | 3510 12th Street, Suite #600, Lewiston, ID 83501 | 2012-02-17 |
| 1306134077 | Rowena Kathryn Jackson | Counselor | 531 Bryden Avenue, Lewiston, ID 83501 | 2011-07-15 |
| 1912290388 | Staci Leanne Truby | Massage Therapist | 717 'd' Street, Lewiston, ID 83501 | 2011-05-18 |
| 1093040685 | Sharie Ann Uhlorn | Registered Nurse | 1837 Alder Court, Lewiston, ID 83501 | 2009-10-15 |
| Find all providers in zip 83501 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689200453 | Elise M Staab | Counselor | 301 Main St Ste 204, Lewiston, ID 83501-1819 | 2020-03-12 |
| 1295394229 | Reliable Services of Maine, LLC | Counselor | 256 Bartlett St, Lewiston, ME 04240-6501 | 2019-06-12 |
| 1124592365 | Crystal Ann Nystrom | Counselor | 2335 Main St, Lewiston, ID 83501-3242 | 2019-01-21 |
| 1861922478 | Seth Toothaker | Counselor | 1190 Lisbon Street, Lewiston, ME 04240 | 2017-06-15 |
| 1720400294 | Sequel Alliance Family Services, LLC | Counselor | 141 9th St Ste 1, Lewiston, ID 83501-2136 | 2014-01-17 |
| 1760804900 | Traci H Kent | Counselor | 79 N Main, Lewiston, UT 84320 | 2014-01-07 |
| 1528323318 | Margaret Mchenry Evans | Counselor | 15a Westminster St, Lewiston, ME 04240-3531 | 2012-07-09 |
| 1952676900 | Elizabeth Lee Hess-almubarak | Counselor | 538 Karin Ave, Lewiston, ID 83501-3866 | 2012-03-08 |
| 1972746519 | Kindra Hibbard | Counselor | 312 Miller St, Lewiston, ID 83501-1944 | 2009-04-13 |
| 1104013267 | Rebecca Ann Yarbrough | Counselor | 151 N. Temple Streeet, Thomas J. Mcmahon Elementry School, Lewiston, ME 04240-3350 | 2007-10-02 |
| Find all providers in LEWISTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.