LIVING WATERS COORDINATED COMMUNITIES, INC. (NPI# 1215153432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215153432 |
| Entity Type | Organization |
| Organization Name | LIVING WATERS COORDINATED COMMUNITIES, INC. |
| Other Organization Name | PAIN MANAGEMENT PSYCHOLOGY |
| Practice Address |
2108 N Ironwood Center Dr Coeur D Alene ID 83814 |
| Mailing Address |
212 W Ironwood Dr Suite D311 Coeur D Alene ID 83814-1403 |
| Practice Telephone | 2086760926 |
| Practice Fax Number | 2086760926 |
| Mailing Telephone | 2086760926 |
| Mailing Fax Number | 2086760926 |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2007-09-28 |
| Authorized Official Name | DR. LAVERL H WILHELM (PRESIDENT, PSYCHOLOGIST) |
| Authorized Official Telephone | 2086760926 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
PSYCHOLOGY 20206 | ID | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Pain Management Psychology | Doing Business As Name - Organization |
| Street Address |
2108 N IRONWOOD CENTER DR |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477162675 | Dehra Mcfaddan | Social Worker | 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 | 2020-07-24 |
| 1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
| 1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
| 1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
| 1730740465 | Connor Williams | Physical Therapist | 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 | 2019-06-24 |
| 1912480153 | Nadine M Lewis | Social Worker | 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 | 2018-09-13 |
| 1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
| 1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
| 1881113413 | Brevity Treatment Services | Counselor | 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 | 2017-09-14 |
| 1366969628 | Jennifer La Gina Highfield | Massage Therapist | 1104 N Ste B, Coeur D Alene, ID 83814 | 2017-08-28 |
| Find all providers in zip 83814 | ||||
| Taxonomy Code | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699912287 | Rit Clinics | Clinic/Center | 1188 Call Creek Dr, Pocatello, ID 83201-3000 | 2009-01-19 |
| 1265613905 | The Pain Center | Clinic/Center | 1673 W. Shoreline Dr., Ste 100, Boise, ID 83702 | 2007-11-23 |
| 1942813134 | Phoenix Health LLC | Clinic/Center | 3142 W Belltower Dr, Meridian, ID 83646-4882 | 2020-08-26 |
| 1316305519 | Quality Sleep Anesthesia P.C. | Clinic/Center | 3155 Channing Way Ste A, Idaho Falls, ID 83404 | 2016-02-02 |
| 1982093357 | Pain Care Clinic of Idaho, P.C. | Clinic/Center | 742 E State St, Suite 150, Eagle, ID 83616-5941 | 2015-01-22 |
| 1942571229 | Osteoarthritis Centers of America Medical Group PC | Clinic/Center | 1097 N Rosario St, Suite 110, Meridian, ID 83642-8095 | 2012-01-19 |
| 1740582303 | Pain Center Inc | Clinic/Center | 633 N 4th St, Boise, ID 83702-4510 | 2010-12-02 |
| 1063725083 | Pain Specialists of Idaho | Clinic/Center | 2375 E Sunnyside Rd, Suite 'j', Idaho Falls, ID 83404-8280 | 2010-07-19 |
| 1669658779 | The Pain Center | Clinic/Center | 1673 Shoreline Dr, Ste 140, Boise, ID 83702-6750 | 2008-01-18 |
| 1194826750 | Catherine L. Linderman Md Pllc | Clinic/Center | 2375 E Sunnyside Rd, Suite A, Idaho Falls, ID 83404-8280 | 2006-09-26 |
| Find all providers with the same taxonomy | ||||
| City | COEUR D ALENE |
| Zip Code | 83814 |
Please comment or provide details below to improve the information on LIVING WATERS COORDINATED COMMUNITIES, INC..
| 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.