WELLNESS ENHANCEMENT CENTER OF IDAHO INC. (NPI# 1417370990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417370990 |
| Entity Type | Organization |
| Organization Name | WELLNESS ENHANCEMENT CENTER OF IDAHO INC. |
| Practice Address |
1111 W Ironwood Dr Ste B Coeur D Alene ID 83814-2604 |
| Practice Telephone | 2086641594 |
| Practice Fax Number | 2086645867 |
| Mailing Telephone | 2086641594 |
| Mailing Fax Number | 2086645867 |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2020-03-10 |
| Authorized Official Name | MR. ROBERT KEITH WYATT (PRESIDENT) |
| Authorized Official Telephone | 2085036298 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | MHC-421 | ID | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 807823900 | 05 |
| Street Address |
1111 W IRONWOOD DR STE B |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83814-2604 |
| 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 | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720636681 | Soar Behavior Services Idaho | Community/Behavioral Health | 2501 E Sherman Ave Apt 415, Coeur D Alene, ID 83814-5855 | 2019-09-03 |
| 1700394715 | Restart Counseling Pllc | Community/Behavioral Health | 1625 N 4th St Ste 102c, Coeur D Alene, ID 83814-6178 | 2018-01-12 |
| 1609328582 | Alpha Counseling | Community/Behavioral Health | 1410 Lincoln Way, Coeur D Alene, ID 83814-2300 | 2016-10-26 |
| 1154689727 | Monarch Mental Health | Community/Behavioral Health | 1713 E Sherman Ave, Coeur D Alene, ID 83814-5326 | 2012-05-02 |
| 1003180118 | Restored Paths | Community/Behavioral Health | 109 E Harrison Ave, Coeur D Alene, ID 83814-3238 | 2012-03-07 |
| 1134320104 | White Pine Counseling | Community/Behavioral Health | 1104 W Ironwood Dr Ste A, Coeur D Alene, ID 83814-2605 | 2007-05-29 |
| 1104032689 | Northwest Behavioral Healthcare | Community/Behavioral Health | 2190 W Ironwood Center Dr, Coeur D Alene, ID 83814-2695 | 2007-05-14 |
| 1033322557 | Mental Wellness Centers | Community/Behavioral Health | 500 N Government Way Ste 100, Coeur D Alene, ID 83814-2976 | 2007-05-08 |
| 1487875456 | Alternative Community Enrichment Services | Community/Behavioral Health | 1103 E Sherman Ave, Coeur D Alene, ID 83814-4154 | 2007-05-01 |
| 1871713925 | Mental Wellness Clinic of Coeur D Alene Inc | Community/Behavioral Health | 1105 W Ironwood Dr, Coeur D Alene, ID 83814-2613 | 2007-04-30 |
| Find all providers in COEUR D ALENE | ||||
| City | COEUR D ALENE |
| Zip Code | 83814 |
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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.