BRICK HOUSE RECOVERY (NPI# 1770987844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770987844 |
| Entity Type | Organization |
| Organization Name | BRICK HOUSE RECOVERY |
| Practice Address |
3663 N Lakeharbor Ln Boise ID 83703 |
| Mailing Address |
3663 N Lakeharbor Ln Boise ID 83703-6913 |
| Practice Telephone | 8013501716 |
| Practice Fax Number | 2082864292 |
| Mailing Telephone | 8013501716 |
| Mailing Fax Number | 2082864292 |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2019-12-30 |
| Authorized Official Name | JASON D COOMBS (CEO) |
| Authorized Official Telephone | 8013501716 |
| Authorized Official Credential | MPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
ID | Behavioral Health & Social Service Providers | |
| N | 251S00000X | Community/Behavioral Health | ID | Agencies | |
| N | 101Y00000X | Counselor | ID | Behavioral Health & Social Service Providers | |
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
ID | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Renaissance Ranch | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1125 E Pine Ave, Meridian, ID 836425955 | 8013501716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710538863 | Brick House Recovery | Case Management | 1020 Land Bank St, Idaho Falls, ID 83402-1809 | 2019-09-20 |
| 1962050989 | Brick House Recovery | Counselor | 1020 Land Bank St, Idaho Falls, ID 83402-1809 | 2019-09-03 |
| 1083150296 | Brick House Recovery | Community/Behavioral Health | 1125 E Pine Ave, Meridian, ID 83642-5955 | 2017-01-11 |
| Street Address |
3663 N LAKEHARBOR LN |
| City | BOISE |
| State | ID |
| Zip Code | 83703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659983278 | Franz Joseph Andersen | Social Worker | 3663 N Lakeharbor Ln, Boise, ID 83703-6913 | 2020-08-17 |
| 1851938237 | Corry Tomlinson Nordby | Counselor | 3663 N Lakeharbor Ln, Boise, ID 83703-6913 | 2019-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386203974 | Dylan Roy | Chiropractor | 5632 W State Street, Boise, ID 83703 | 2019-06-07 |
| 1124476858 | Tidwell Social Work Services and Consulting, Inc. | Community/Behavioral Health | 5999 W. State St., Boise, ID 83703 | 2016-06-03 |
| 1801251244 | Rebecca Lynn Cushing | Massage Therapist | 5909 W. State St, Boise, ID 83703 | 2015-12-30 |
| 1790181675 | Malinda Poe | Counselor | 4440 W Taft St, Boise, ID 83703 | 2014-11-05 |
| 1689079469 | Ashley Harker | Massage Therapist | 5909 W. State St., Boise, ID 83703 | 2014-10-23 |
| 1033512538 | Ryan Warburton | Physical Therapist | 2999 N Lakeshore Lane, Ste 120, Boise, ID 83703 | 2014-09-29 |
| 1710386008 | Suzanne Iannaccone | Social Worker | 4090 W State St Ste 221, Boise, ID 83703 | 2014-08-22 |
| 1588092464 | Becky L. Marks | Social Worker | 3858 N. Garden Center Way, Suite 204, Boise, ID 83703 | 2013-10-31 |
| 1700219169 | Pohley Richey | Dietitian, Registered | 6052 W State Street, Boise, ID 83703 | 2013-08-20 |
| 1023392636 | Nancy Lynn Tate | Physician Assistant | 3668 North Lake Harbor Ln, Boise, ID 83703 | 2011-09-30 |
| Find all providers in zip 83703 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
| 1578195285 | Kara Taylor | Counselor | 9196 W Barnes St., Boise, ID 83709 | 2020-02-11 |
| 1508339409 | Joyce Ella Turnboom | Counselor | 3213 N Tamarack Dr, Boise, ID 83703-4543 | 2019-01-03 |
| 1609229012 | Community Services Counseling | Counselor | 963 S Orchard St Ste B, Boise, ID 83705-1962 | 2016-07-20 |
| 1508221391 | Elisha L. Garrison | Counselor | 9196 W. Barnes Street, Boise, ID 83709 | 2015-12-21 |
| 1386026649 | Erica Ann Lopez | Counselor | 9336 W Chad St, Boise, ID 83709-0558 | 2015-06-23 |
| 1417339730 | Michael Biggins | Counselor | 3804 W Normandie Dr, Boise, ID 83705-4729 | 2015-06-23 |
| 1013313006 | Caitlin Goicoechea | Counselor | 8950 W Emerald St Ste 178, Boise, ID 83704-8296 | 2014-11-18 |
| 1073915534 | Nichole Adele Herold | Counselor | 8950 W. Emerald, Boise, ID 83704-4854 | 2014-09-16 |
| 1346672946 | Janice Andrews | Counselor | 8620 W Emerald St Ste 150, Boise, ID 83704-4839 | 2013-08-06 |
| Find all providers in BOISE | ||||
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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.