LOST RIVER WELLNESS (NPI# 1497235469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497235469 |
| Entity Type | Organization |
| Organization Name | LOST RIVER WELLNESS |
| Other Organization Name | LOST RIVER WELLNESS |
| Practice Address |
3080 E Gentry Way Ste 100 Meridian ID 83642-3060 |
| Practice Telephone | 2088102318 |
| Mailing Telephone | 2084841447 |
| Enumeration Date | 2018-08-18 |
| Last Update Date | 2018-11-28 |
| Authorized Official Name | JEFF BROWN (CHIEF BUSINESS OFFICER) |
| Authorized Official Telephone | 2084841447 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
M11538 | ID | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Lost River Wellness | Doing Business As Name - Organization |
| Street Address |
3080 E GENTRY WAY STE 100 |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-3060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295138261 | At Home Medical Partners, Pllc | Nurse Practitioner | 3080 E Gentry Way Ste 100, Meridian, ID 83642-3060 | 2014-10-03 |
| 1306311824 | Inland Community Housecalls, Corp. | Nurse Practitioner | 3080 E Gentry Way Ste 100, Meridian, ID 83642-3060 | 2018-10-11 |
| 1194275693 | Joslyn Dresser | Nurse Practitioner | 3080 E Gentry Way Ste 100, Meridian, ID 83642 | 2016-10-07 |
| 1285014118 | Lyon Medical LLC | Hospitalist | 3080 E Gentry Way Ste 100, Meridian, ID 83642-3060 | 2015-06-05 |
| 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 | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437621646 | Joanne Burgio Phd LLC | Clinic/Center | 3061 S Meridian Rd Ste 150, Meridian, ID 83642-7962 | 2018-12-28 |
| 1346759495 | Pacific Mind Institute | Clinic/Center | 2596 N Stokesberry Pl Ste 165, Meridian, ID 83646-6281 | 2017-09-20 |
| 1477086932 | Medical Consulting Services, LLC | Clinic/Center | 3023 E Copper Point Dr, Ste 110, Meridian, ID 83642 | 2017-04-11 |
| 1821344367 | State Avenue Offices | Clinic/Center | 39 E State Ave, Meridian, ID 83642-2342 | 2012-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942808019 | Helping Hearts Counseling Center, Pllc | Clinic/Center | 310 Cleveland Blvd, Caldwell, ID 83605-3624 | 2020-10-12 |
| 1811502438 | Dale Wilson Counseling and Evaluation | Clinic/Center | 6126 W State St Ste 101, Boise, ID 83703-2741 | 2020-09-10 |
| 1144843285 | Whole Health Counseling LLC | Clinic/Center | 2616 W Jefferson St, Boise, ID 83702-4713 | 2020-05-23 |
| 1033740865 | Jackie Nelson, Pllc | Clinic/Center | 202 N 9th St Ste 401c, Boise, ID 83702-5770 | 2020-01-30 |
| 1700394822 | Lookout Behavioral Health LLC | Clinic/Center | 7905 N Meadowlark Way Ste A, Coeur D Alene, ID 83815-5041 | 2018-01-11 |
| 1336599976 | Easy Go Express | Clinic/Center | 3551 W Antelope Rd, Moore, ID 83255-8754 | 2016-06-14 |
| 1669808614 | Integrated Interventions LLC | Clinic/Center | 2482 E. Glacier Rd., Hayden Lake, ID 83835 | 2013-09-23 |
| 1447695630 | Susan M. Beglinger, Ltd | Clinic/Center | 206 E Indiana Ave, Suite 112, Coeur D Alene, ID 83814-2969 | 2013-05-01 |
| 1750621116 | New Horizons Mental Wellness Clinics | Clinic/Center | 1352 E. Center, Suite A, Pocatello, ID 83201-4773 | 2013-02-22 |
| 1518217983 | Aspenwood Counseling and Behavior Center | Clinic/Center | 225 South Street, Albion, ID 83311-0111 | 2012-09-13 |
| 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.