BRICK HOUSE RECOVERY (NPI# 1083150296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083150296 |
| Entity Type | Organization |
| Organization Name | BRICK HOUSE RECOVERY |
| Other Organization Name | RENAISSANCE RANCH |
| Practice Address |
1125 E Pine Ave Meridian ID 83642-5955 |
| Practice Telephone | 2082864274 |
| Mailing Telephone | 2082864274 |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2017-01-11 |
| Authorized Official Name | JASON DOUGLAS COOMBS (EXECUTIVE DIRECTOR/OWNER) |
| Authorized Official Telephone | 8013501716 |
| Authorized Official Credential | MPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | ID | Agencies | |
| Y | 324500000X | Substance Abuse Rehabilitation Facility | ID | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Renaissance Ranch | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770987844 | Brick House Recovery | Counselor | 3663 N Lakeharbor Ln, Boise, ID 83703 | 2014-10-17 |
| 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 |
| Street Address |
1125 E PINE AVE |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-5955 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457722092 | Bear Tooth Laboratory, LLC | Clinical Medical Laboratory | 1125 E Pine Ave, Ste B, Meridian, ID 83642-5955 | 2015-10-08 |
| 1457906620 | Angela Kay Potts | Counselor | 1125 E Pine Ave, Meridian, ID 83642-5955 | 2019-08-05 |
| 1205489234 | Tiffanie Diane Long | Counselor | 1125 E Pine Ave, Meridian, ID 83642-5955 | 2019-07-18 |
| 1053973628 | Sarah Elizabeth Skoog | Counselor | 1125 E Pine Ave, Meridian, ID 83642-5955 | 2019-07-03 |
| 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 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871150185 | King's Peak Investments, Inc. | Substance Abuse Rehabilitation Facility | 8898 Idaho 45, Nampa, ID 83686 | 2019-05-22 |
| 1861983413 | Moonlight Mountain Recovery, Inc | Substance Abuse Rehabilitation Facility | 5230 W Moonlight Mine Rd, Pocatello, ID 83201-9013 | 2018-05-18 |
| 1437685799 | Road To Recovery, Inc. | Substance Abuse Rehabilitation Facility | 165 W. Main, Lava Hot Springs, ID 83246 | 2017-05-05 |
| 1033573993 | Therapy In Motion Inc | Substance Abuse Rehabilitation Facility | 178 West Main Street, Lava Hot Springs, ID 83246 | 2016-04-07 |
| 1992179253 | North Idaho Ranch Recovery Clinic | Substance Abuse Rehabilitation Facility | 4570 S Stach Rd, Coeur D Alene, ID 83814-7955 | 2015-11-23 |
| 1154709087 | Northpoint Recovery LLC | Substance Abuse Rehabilitation Facility | 10787 Ustick Rd, Boise, ID 83713-5104 | 2015-05-12 |
| 1346633849 | Therapy In Motion Inc | Substance Abuse Rehabilitation Facility | 165 West Main St, Lava Hot Springs, ID 83246 | 2015-03-09 |
| 1518357649 | Sage Recovery LLC | Substance Abuse Rehabilitation Facility | 2995 N Cole Rd Ste 255, Boise, ID 83704-5976 | 2015-01-27 |
| 1083977656 | Higher Ground Retreat, LLC | Substance Abuse Rehabilitation Facility | 17626 Deer Flat Rd, Caldwell, ID 83607-9779 | 2012-06-19 |
| 1902175979 | Rainbow's End Recovery Center LLC | Substance Abuse Rehabilitation Facility | 25341 N. Highway 93, Challis, ID 83226 | 2011-12-21 |
| Find all providers with the same taxonomy | ||||
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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.