MERIDIAN HEALTHCARE, INC. (NPI# 1699251058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699251058 |
| Entity Type | Organization |
| Organization Name | MERIDIAN HEALTHCARE, INC. |
| Practice Address |
1351 W Pine Ave Meridian ID 83642-2010 |
| Practice Telephone | 2088887049 |
| Mailing Telephone | 2088887049 |
| Enumeration Date | 2018-07-18 |
| Last Update Date | 2018-07-18 |
| Authorized Official Name | SOON BURNAM (TREASURER) |
| Authorized Official Telephone | 2088887049 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851337323 | Meridian Healthcare, Inc. | Skilled Nursing Facility | 1515 Lamberts Mill Rd, Westfield, NJ 07090-4763 | 2006-06-21 |
| 1649212069 | Meridian Healthcare, Inc. | Skilled Nursing Facility | 3227 Bel Pre Rd, Silver Spring, MD 20906-2423 | 2006-06-11 |
| 1932685583 | Meridian Healthcare, Inc. | Skilled Nursing Facility | 1351 W Pine Ave, Meridian, ID 83642-2010 | 2018-07-17 |
| 1043256514 | Meridian Healthcare, Inc. | Skilled Nursing Facility | 3001 E Evesham Rd, Voorhees, NJ 08043-9547 | 2006-06-21 |
| 1306887716 | Meridian Healthcare, Inc. | Skilled Nursing Facility | 7700 York Rd, Towson, MD 21204-7513 | 2006-06-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | MERIDIAN HEALTHCARE, INC. | 101 East State Street, Kennett Square, PA 19348 |
| Vermont Business Registrations | MERIDIAN HEALTHCARE, INC. | 101 E. State Street, Kennett Square, PA 19348 |
| Street Address |
1351 W PINE AVE |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-2010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639126493 | Sunbridge Healthcare LLC | Assisted Living Facility | 1351 W Pine Ave, Meridian, ID 83642-5031 | 2006-05-27 |
| 1245704931 | Leslie Leet LLC | Social Worker | 1351 W Pine Ave, Meridian, ID 83642-2010 | 2019-01-15 |
| 1932685583 | Meridian Healthcare, Inc. | Skilled Nursing Facility | 1351 W Pine Ave, Meridian, ID 83642-2010 | 2018-07-17 |
| 1366943664 | Alyssa Smith | Technician, Other | 1351 W Pine Ave, Meridian, ID 83642-5031 | 2018-02-22 |
| 1841642857 | Kelly Elizabeth Sills | Occupational Therapist | 1351 W Pine Ave, Meridian, ID 83642-5031 | 2016-07-01 |
| 1235594607 | Eric Reed Mcevoy | Physical Therapist | 1351 W Pine Ave, Meridian, ID 83642-5031 | 2015-12-29 |
| 1639541329 | Casey Michel | Physical Therapist | 1351 W Pine Ave, Meridian, ID 83642-5031 | 2015-10-21 |
| 1427425453 | Jace Eyre | Physical Therapy Assistant | 1351 W Pine Ave, Meridian, ID 83642-5031 | 2015-08-25 |
| 1558754481 | Tony Lane Grant | Physical Therapy Assistant | 1351 W Pine Ave, Meridian, ID 83642-5031 | 2015-03-17 |
| 1073905055 | Rebecca Baxter | Occupational Therapy Assistant | 1351 W Pine Ave, Meridian, ID 83642-5031 | 2015-02-27 |
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| 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 |
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| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548886963 | Diamond View Care Properties, LLC | Assisted Living Facility | 3570 E Amity Rd, Meridian, ID 83642-7014 | 2020-06-22 |
| 1790309045 | Grace At Fairview Lakes LLC | Assisted Living Facility | 1960 N Lakes Pl, Meridian, ID 83646-5939 | 2020-06-02 |
| 1356977466 | Tanabell Health Services Inc | Assisted Living Facility | 2584 E Magic View Dr, Meridian, ID 83646 | 2020-03-20 |
| 1508329343 | Veranda Senior Living LLC | Assisted Living Facility | 6280 N Fox Run Way, Meridian, ID 83646-6791 | 2019-04-09 |
| 1225313737 | Edgewood Spring Creek Ustick, LLC | Assisted Living Facility | 3165 Meridian Rd, Meridian, ID 83646 | 2011-10-15 |
| 1144537986 | Alpine Meadows Assisted Living, LLC | Assisted Living Facility | 1695 S Locust Grove Rd, Meridian, ID 83642-6620 | 2010-08-31 |
| 1639406481 | Arrowrock Assisted Living LLC | Assisted Living Facility | 1448 W Crest Wood Dr, Meridian, ID 83642-2498 | 2009-11-13 |
| 1376674622 | Spring Creek Idaho, LLC | Assisted Living Facility | 175 E Calderwood Dr, Meridian, ID 83642-7482 | 2007-03-08 |
| 1639126493 | Sunbridge Healthcare LLC | Assisted Living Facility | 1351 W Pine Ave, Meridian, ID 83642-5031 | 2006-05-27 |
| 1891078705 | Edgewood Spring Creek Meridian, LLC | Assisted Living Facility | 175 E Calderwood Dr, Meridian, ID 83642-7482 | 2011-09-27 |
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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.