HOLLY LANE REHABILITATION AND HEALTHCARE CENTER, LLC (NPI# 1053553461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053553461 |
| Entity Type | Organization |
| Organization Name | HOLLY LANE REHABILITATION AND HEALTHCARE CENTER, LLC |
| Practice Address |
2105 12th Ave Rd Nampa ID 83686-6312 |
| Practice Telephone | 2084675721 |
| Practice Fax Number | 2084672748 |
| Mailing Telephone | 2084675721 |
| Mailing Fax Number | 2084672748 |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2016-07-11 |
| Authorized Official Name | CRAIG E ROBINSON (PRESIDENT) |
| Authorized Official Telephone | 9019377994 |
| Is Organization Subpart | Y |
| Parent Organization Name | ORIANNA HEALTH SYSTEMS, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | APPLIED FOR | ID | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | APPLIED FOR | 05 |
| Street Address |
2105 12TH AVE RD |
| City | NAMPA |
| State | ID |
| Zip Code | 83686-6312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477503076 | Trinity Mission Health & Rehab of Holly, Lp | Skilled Nursing Facility | 2105 12th Ave Rd, Nampa, ID 83686-6312 | 2006-05-12 |
| 1699208280 | Canyon County of Cascadia LLC | Skilled Nursing Facility | 2105 12th Ave Rd, Nampa, ID 83686-6312 | 2017-04-10 |
| 1952851248 | Stephanie Rogers | Occupational Therapist | 2105 12th Ave Rd, Nampa, ID 83686-6312 | 2016-10-11 |
| 1659829869 | Ian Clint Idayan | Physical Therapist | 2105 12th Ave Rd, Nampa, ID 83686-6312 | 2016-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184255960 | Kristine Lynn Fitts-eisenbrandt | Social Worker | 270 W. Gerogia Ave., Nampa, ID 83686 | 2020-01-30 |
| 1669025706 | Vitality Family Chiropractic, Pllc | Chiropractor | 3189 E Greenhurst Rd, Nampa, ID 83686 | 2019-07-18 |
| 1871150185 | King's Peak Investments, Inc. | Substance Abuse Rehabilitation Facility | 8898 Idaho 45, Nampa, ID 83686 | 2019-05-22 |
| 1154805786 | Jmj Nampa LLC | Dentist | 914 12th Ave Rd, Nampa, ID 83686 | 2018-09-19 |
| 1518448703 | Michel Cox | Pharmacy Technician | 2219 12th Ave S, Nampa, ID 83686 | 2018-08-24 |
| 1437504909 | 5 Peppers Inc | Family Medicine | 217 W. Georgia Ave. Ste 120, Nampa, ID 83686 | 2016-05-03 |
| 1811369549 | Anna Stoia | Physician Assistant | 4401 E. Tuscany Ave., Nampa, ID 83686 | 2015-10-21 |
| 1144699307 | Jamie Green | Social Worker | 112 12th Avenue Rd., Nampa, ID 83686 | 2015-09-17 |
| 1174927933 | Bower Chiropractic Inc | Chiropractor | 304 12th Ave Rd, Nampa, ID 83686 | 2014-10-22 |
| 1285037093 | Rosemary Phelps | Registered Nurse | 353 W. Iowa, Nampa, ID 83686 | 2014-10-07 |
| Find all providers in zip 83686 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356867683 | Nampa of Cascadia, LLC | Skilled Nursing Facility | 900 North Happy Valley Rd, Nampa, ID 83687 | 2017-08-18 |
| 1265455273 | Kindred Nursing Centers West, LLC | Skilled Nursing Facility | 404 N Horton St, Nampa, ID 83651-6541 | 2006-07-25 |
| 1477503076 | Trinity Mission Health & Rehab of Holly, Lp | Skilled Nursing Facility | 2105 12th Ave Rd, Nampa, ID 83686-6312 | 2006-05-12 |
| 1558311274 | Trinity Mission Health & Rehab of Midland, Lp | Skilled Nursing Facility | 46 N Midland Blvd, Nampa, ID 83651-2145 | 2006-05-11 |
| 1912418229 | Nampa West of Cascadia, LLC | Skilled Nursing Facility | 404 N Horton St, Nampa, ID 83651-6541 | 2017-10-13 |
| 1699208280 | Canyon County of Cascadia LLC | Skilled Nursing Facility | 2105 12th Ave Rd, Nampa, ID 83686-6312 | 2017-04-10 |
| 1083146484 | Midland Nampa Healthcare, Inc. | Skilled Nursing Facility | 46 N Midland Blvd, Nampa, ID 83651-2145 | 2017-04-03 |
| 1891148979 | Care Center Nampa Inc | Skilled Nursing Facility | 1127 Caldwell Blvd, Nampa, ID 83651-1701 | 2016-07-13 |
| 1902048366 | Midland Rehabilitation and Healthcare Center, LLC | Skilled Nursing Facility | 46 N Midland Blvd, Nampa, ID 83651-2145 | 2009-04-01 |
| 1104977479 | Development Enterprises, Inc. | Skilled Nursing Facility | 1127 Caldwell Blvd, Nampa, ID 83651-1719 | 2007-01-15 |
| Find all providers in NAMPA | ||||
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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.