JENNDA LLC (NPI# 1356968895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356968895 |
| Entity Type | Organization |
| Organization Name | JENNDA LLC |
| Practice Address |
4305 N Royal St Coeur D Alene ID 83815-9237 |
| Mailing Address |
Po Box 19604 Spokane WA 99219-0034 |
| Practice Telephone | 2088898594 |
| Mailing Telephone | 2088898594 |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2020-07-01 |
| Authorized Official Name | JENNIFER ANN HAWKINS (CO-OWNER) |
| Authorized Official Telephone | 2088898594 |
| Authorized Official Credential | MS, SUDP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | JENNDA LLC | 4305 N Royal St, Coeur D Alene, ID 83815-9237 |
| Street Address |
4305 N ROYAL ST |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83815-9237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790133163 | Christine Lee Stanton | Speech-Language Pathologist | 3825 N. Blalock Drive, Coeur D'alene, ID 83815 | 2016-05-26 |
| 1578921961 | Kayla Wearne | Speech-Language Pathologist | 917 W Canfield Avenue, Coeur D'alene, ID 83815 | 2016-02-01 |
| 1770954794 | William Strong | Speech-Language Pathologist | 3902 Broken Arrow Rd, Coeur D Alene, ID 83815 | 2015-10-16 |
| 1235517079 | Denny Bordeaux | Emergency Medical Technician, Paramedic | 7294 Downing Lane, Coeur D Alene, ID 83815 | 2015-05-13 |
| 1689075657 | Barbara Campbell | Pharmacist | W 201 Neider Rd., Coeur D'alene, ID 83815 | 2014-09-10 |
| 1710313671 | Sean Cooper | Pharmacist | W. 201 Neider Rd., Coeur D' Alene, ID 83815 | 2013-09-23 |
| 1275871329 | Lake City Dental | Dentist | 6176 Government Way, Coeur D'alene, ID 83815 | 2013-01-24 |
| 1881972701 | A Better Personal Care Inc | In Home Supportive Care | 3115 N Government Way Ste 2, Coeur D'alene, ID 83815 | 2011-07-26 |
| 1013206895 | Robert Sperry | Pharmacist | 41650 W Maricopacg Hwy., Maricopa, AZ 83815 | 2011-04-01 |
| 1629304670 | Marciea W. Buckley | Social Worker | 109 Harrison Ave, Coeur D' Alene, ID 83815 | 2009-10-27 |
| Find all providers in zip 83815 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346602281 | Valerie Jones | Clinic/Center | 911 South Highway 30, Oats Family Center, Heyburn, ID 83336 | 2016-03-21 |
| 1912335217 | Lifestyle Changes Counseling | Clinic/Center | 371 Locust St S, Twin Falls, ID 83301-7837 | 2013-10-23 |
| 1194962829 | Jx2 LLC | Clinic/Center | 1253 N Cole Rd, Ste 100, Boise, ID 83704-8647 | 2009-01-16 |
| 1295379865 | High Country Behavioral Health | Clinic/Center | 2420 E 25th St, Idaho Falls, ID 83404-7549 | 2019-11-06 |
| 1699166637 | Access Behavioral Health Services | Clinic/Center | 1276 W River St Ste 100, Boise, ID 83702-7083 | 2015-02-12 |
| 1427450055 | Ada County Problem Solving Courts | Clinic/Center | 400 N Benjamin Ln, Suite 200, Boise, ID 83704-5094 | 2014-09-26 |
| 1962802462 | A Fresh Start Recovery Services | Clinic/Center | 1123 Blaine St, Caldwell, ID 83605-3835 | 2014-09-03 |
| 1336553692 | Midvalley Healthcare Pllc | Clinic/Center | 2321 E Gala St, Suite 3, Meridian, ID 83642-7692 | 2014-06-16 |
| 1396176582 | Badger Inc. | Clinic/Center | 1970 E 17th St, Ste 202, Idaho Falls, ID 83404-8014 | 2013-12-12 |
| 1992132427 | Tueller Counseling | Clinic/Center | 2275 W Broadway St, Suite G, Idaho Falls, ID 83402-2902 | 2013-09-30 |
| Find all providers with the same taxonomy | ||||
| City | COEUR D ALENE |
| Zip Code | 83815 |
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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.