PREFERRED COMMUNITY HOMES, LLC (NPI# 1205970399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1205970399 |
Entity Type | Organization |
Organization Name | PREFERRED COMMUNITY HOMES, LLC |
Other Organization Name | PREFERRED COMMUNITY HOMES - COUGAR |
Practice Address |
1230 E Cougar Creek Dr Meridian ID 83642-7807 |
Mailing Address |
3155 River Rd S Ste 100 Salem OR 97302-9819 |
Practice Telephone | 2088884417 |
Mailing Telephone | 5033625235 |
Mailing Fax Number | 5035853267 |
Enumeration Date | 2007-02-20 |
Last Update Date | 2020-08-22 |
Authorized Official Name | MR. JASON MCARTHUR (CFO) |
Authorized Official Telephone | 5033625235 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | ID | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AK | LT035ID | 05 |
Other Name | Type Code |
---|---|
Preferred Community Homes - Cougar | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689989816 | Preferred Community Homes, LLC | Community/Behavioral Health | 440 W Pennwood St Ste 200, Meridian, ID 83642-8602 | 2010-08-12 |
1902027303 | Preferred Community Homes, LLC | Nursing Care | 7091 W Emerald St, Boise, ID 83704-8618 | 2007-05-01 |
1104960707 | Preferred Community Homes, LLC | Intermediate Care Facility, Mentally Retarded | 699 S Otter Ave, Meridian, ID 83642-6144 | 2007-02-16 |
1154508471 | Preferred Community Homes, LLC | Case Management | 7091 W Emerald St, Boise, ID 83704-8618 | 2008-01-29 |
Street Address |
1230 E COUGAR CREEK DR |
City | MERIDIAN |
State | ID |
Zip Code | 83642-7807 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
Find all providers in zip 83642 |
Taxonomy Code | 315P00000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Intermediate Care Facility, Mentally Retarded |
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942337787 | Preferred Community Homes, LLC. | Intermediate Care Facility, Mentally Retarded | 398 E Edgar Ct, Meridian, ID 83642-4422 | 2007-02-28 |
1295862035 | Preferred Community Homes, LLC. | Intermediate Care Facility, Mentally Retarded | 2226 W Sonoma Dr, Meridian, ID 83642-4358 | 2007-02-28 |
1245367085 | Preferred Community Homes, LLC. | Intermediate Care Facility, Mentally Retarded | 2273 S Gull Cove Pl, Meridian, ID 83642-6591 | 2007-02-28 |
1851428692 | Preferred Community Homes, LLC. | Intermediate Care Facility, Mentally Retarded | 2774 N Old Stone Way, Meridian, ID 83642-3842 | 2007-02-28 |
1104960707 | Preferred Community Homes, LLC | Intermediate Care Facility, Mentally Retarded | 699 S Otter Ave, Meridian, ID 83642-6144 | 2007-02-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962755868 | State of Idaho | Intermediate Care Facility, Mentally Retarded | 1182 West Kyler Ave, Hayden, ID 83835 | 2012-10-17 |
1861742736 | Brenda Elaine Dilbeck | Intermediate Care Facility, Mentally Retarded | 4515 N Glenwood St, Boise, ID 83704-3012 | 2012-09-18 |
1902110380 | Belmont Management, Inc. | Intermediate Care Facility, Mentally Retarded | 6150 S. 5th Ave, Pocatello, ID 83204 | 2010-07-28 |
1760686687 | Idaho Falls Group Homes | Intermediate Care Facility, Mentally Retarded | 950 Periska Way, Idaho Falls, ID 83402-5141 | 2007-06-13 |
1235333576 | Idaho Falls Group Homes | Intermediate Care Facility, Mentally Retarded | 4360 Wanda St, Ammon, ID 83406-6878 | 2007-06-12 |
1447454798 | Idaho Falls Group Homes | Intermediate Care Facility, Mentally Retarded | 3612 Summit Run Trl, Idaho Falls, ID 83404-8247 | 2007-06-12 |
1730394644 | Independent Living Services, Inc. | Intermediate Care Facility, Mentally Retarded | 11577 Freedom Dr, Boise, ID 83713-3650 | 2007-05-14 |
1013122928 | Independent Living Services, Inc. | Intermediate Care Facility, Mentally Retarded | 10349 Summerwind Dr, Boise, ID 83704-3953 | 2007-05-14 |
1295948941 | Independent Living Services, Inc. | Intermediate Care Facility, Mentally Retarded | 10528 W Milclay St, Boise, ID 83704-3940 | 2007-05-08 |
1487867123 | Independent Living Services, Inc. | Intermediate Care Facility, Mentally Retarded | 1736 N Five Mile Rd, Boise, ID 83713-5408 | 2007-05-08 |
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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.