CLEARWATER CARE CENTER, INC. (NPI# 1740303239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740303239 |
| Entity Type | Organization |
| Organization Name | CLEARWATER CARE CENTER, INC. |
| Other Organization Name | BITTERROOT HOME |
| Practice Address |
1411 Falls Ave E Suite 703 Twin Falls ID 83301-3455 |
| Practice Telephone | 2087348973 |
| Practice Fax Number | 2087341075 |
| Mailing Telephone | 2087348973 |
| Mailing Fax Number | 2087341075 |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | RENE STEPHENS (ADMINISTRATOR) |
| Authorized Official Telephone | 2087348973 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310500000X | Intermediate Care Facility, Mental Illness | ID | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Bitterroot Home | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790202208 | Clearwater Care Center, Inc. | Intermediate Care Facility, Mentally Retarded | 1411 Falls Ave E Ste 703, Twin Falls, ID 83301-3455 | 2017-08-25 |
| 1063635696 | Clearwater Care Center, Inc. | Intermediate Care Facility, Mental Illness | 1411 Falls Ave E, Suite 703, Twin Falls, ID 83301-3455 | 2007-04-11 |
| 1972726503 | Clearwater Care Center, Inc. | Intermediate Care Facility, Mentally Retarded | 1411 Falls Ave E, Suite 703, Twin Falls, ID 83301-3455 | 2007-04-11 |
| 1710100326 | Clearwater Care Center, Inc. | Intermediate Care Facility, Mental Illness | 1411 Falls Ave E, Suite 703, Twin Falls, ID 83301-3455 | 2007-04-11 |
| Street Address |
1411 FALLS AVE E SUITE 703 |
| City | TWIN FALLS |
| State | ID |
| Zip Code | 83301-3455 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821036724 | Intermountain Spine and Orthopedics, PC | Family Medicine | 1411 Falls Ave E, Suite 1301, Twin Falls, ID 83301-3455 | 2006-06-03 |
| 1144509084 | Ford Family Eye Care, P.C. | Optometrist | 1411 Falls Ave E, Suite 105, Twin Falls, ID 83301-3455 | 2011-08-09 |
| 1215233952 | David Tyler Billings | Physical Therapist | 1411 Falls Ave E, Suite 105, Twin Falls, ID 83301-3455 | 2011-01-27 |
| 1427354257 | Michael William Sprague | Physical Therapist | 1411 Falls Ave E, Suite 105, Twin Falls, ID 83301-3455 | 2011-01-26 |
| 1659682912 | Joshua Alan Jenkins | Dentist | 1411 Falls Ave E, #1000c, Twin Falls, ID 83301-3455 | 2010-07-01 |
| 1780813691 | Trent Pryor | Dentist | 1411 Falls Ave E, Suite 1000c, Twin Falls, ID 83301-3455 | 2009-07-13 |
| 1922279785 | Wright Physical Therapy, LLC | Physical Therapist | 1411 Falls Ave E, Suite 105, Twin Falls, ID 83301-3455 | 2008-03-19 |
| 1417162728 | Inclusion South, Inc | Nursing Care | 1411 Falls Ave E, #205, Twin Falls, ID 83301-3455 | 2007-05-11 |
| 1285855759 | Inclusion South, Inc. | Day Training, Developmentally Disabled Services | 1411 Falls Ave E, #205, Twin Falls, ID 83301-3455 | 2007-05-01 |
| 1063635696 | Clearwater Care Center, Inc. | Intermediate Care Facility, Mental Illness | 1411 Falls Ave E, Suite 703, Twin Falls, ID 83301-3455 | 2007-04-11 |
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|---|---|---|---|---|
| 1023645918 | Matthew Anderson | Pharmacist | Dick's Pharmacy, 526 K Shoup Ave W, Twin Falls, ID 83301 | 2020-03-23 |
| 1780146316 | Frontier Pediatric Partners, Pllc | Pediatrics | 1502 Locust Street N #700, Twin Falls, ID 83301 | 2019-04-02 |
| 1972073377 | Wood River Acupuncture | Acupuncturist | 1625 Addison Ave East, Twin Falls, ID 83301 | 2018-11-28 |
| 1235629874 | Lonnie Paul | Counselor | 1092 Eastland Dr N Ste A, Twin Falls, ID 83301 | 2018-05-17 |
| 1679060966 | Christina Jirapha Thongdee | Social Worker | 625 Poleline Road West, Suite 2a, Twin Falls, ID 83301 | 2018-04-23 |
| 1437658499 | Tyrel Kevin Ward | Chiropractor | 2167 Village Park Ave., Suite 100, Twin Falls, ID 83301 | 2018-02-06 |
| 1851836381 | Tanabell Health Services, Inc | Skilled Nursing Facility | 1134 Cheney Drive West, Twin Falls, ID 83301 | 2016-12-19 |
| 1578005195 | Matthew Carter | Physical Therapist | 1053 Eastland Drive, Twin Falls, ID 83301 | 2016-11-14 |
| 1790227783 | Murvat Usmanova | Nurse Practitioner | 775 Pole Line Road W, Suite 203, Twin Falls, ID 83301 | 2016-11-08 |
| 1265894687 | Shawna Fultz | Social Worker | 1201 Fall Ave East Suite C, Twin Falls, ID 83301 | 2016-03-24 |
| Find all providers in zip 83301 | ||||
| Taxonomy Code | 310500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mental Illness |
| A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063635696 | Clearwater Care Center, Inc. | Intermediate Care Facility, Mental Illness | 1411 Falls Ave E, Suite 703, Twin Falls, ID 83301-3455 | 2007-04-11 |
| 1710100326 | Clearwater Care Center, Inc. | Intermediate Care Facility, Mental Illness | 1411 Falls Ave E, Suite 703, Twin Falls, ID 83301-3455 | 2007-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023096757 | Gooding Rehab and Living Center | Intermediate Care Facility, Mental Illness | 1220 Montana St, Gooding, ID 83330-1856 | 2006-01-03 |
| City | TWIN FALLS |
| Zip Code | 83301 |
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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.