STATE HOSPITAL NORTH (NPI# 1598831653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598831653 |
| Entity Type | Organization |
| Organization Name | STATE HOSPITAL NORTH |
| Practice Address |
300 Hospital Dr Orofino ID 83544-9034 |
| Practice Telephone | 2084764511 |
| Practice Fax Number | 2084767898 |
| Mailing Telephone | 2084764511 |
| Mailing Fax Number | 2084767898 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ROBERT BOURASSA (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Telephone | 2084764511 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283Q00000X | Psychiatric Hospital | 24 | ID | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | CLIA | 1400501 | 01 |
| ID | BLUE CROSS OF IDAHO | 00919 | 01 |
| Street Address |
300 HOSPITAL DR |
| City | OROFINO |
| State | ID |
| Zip Code | 83544-9034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457993206 | Alexa Brooks | Physician Assistant | 300 Hospital Dr, Orofino, ID 83544-9034 | 2019-10-14 |
| 1881120889 | Jami Tyler | Registered Nurse | 300 Hospital Dr, Orofino, ID 83544-9034 | 2017-05-11 |
| 1710127527 | Leon W. Jensen | Pharmacist | 300 Hospital Dr, Orofino, ID 83544-9034 | 2009-03-06 |
| 1841354958 | Fraun Flerchinger | Psychiatry & Neurology | 300 Hospital Dr, Orofino, ID 83544-9034 | 2006-12-21 |
| 1366503955 | John Edward Riley | Family Medicine | 300 Hospital Dr, Orofino, ID 83544-9034 | 2006-12-13 |
| 1124194105 | Karla S Eisele | Psychiatry & Neurology | 300 Hospital Dr, Orofino, ID 83544-9034 | 2006-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598229809 | Clearwater Canyon Pharmacy, LLC | Pharmacy | 13020 Us-12, Orofino, ID 83544 | 2019-01-31 |
| 1295130698 | Brian Shapiro | Marriage & Family Therapist | 155 Main Street Stuite C, Orofino, ID 83544 | 2014-10-28 |
| 1942497052 | Jean M. Shropshire | Speech-Language Pathologist | 123 1st St., Orofino, ID 83544 | 2007-10-02 |
| 1417161969 | Jeffrey David Hartshorn | Chiropractor | 437 College Avenue, Orofino, ID 83544 | 2007-05-10 |
| 1598808099 | Orofino Physical Therapy and Wellness Inc | Physical Medicine & Rehabilitation | 1005 Michigan Ave, Orofino, ID 83544 | 2007-02-14 |
| 1083766356 | Adam C. Dayley, O.d., P.C. | Optometrist | 906 Michigan Ave., Orofino, ID 83544 | 2007-01-17 |
| 1710037882 | Douglas L Frank | Pharmacist | 1105 Michigan Avenue, Orofino, ID 83544 | 2007-01-11 |
| 1386718047 | Irene Lamberti | Chiropractor | 437 College Ave., Orofino, ID 83544 | 2006-11-17 |
| 1730281064 | Clearwater County | Ambulance | 1195 Riverside Avenue, Orofino, ID 83544 | 2006-09-05 |
| 1538101050 | Wendi Rene Richardson | Nurse Anesthetist, Certified Registered | 301 Cedar, Clearwater Valley Hospital, Orofino, ID 83544 | 2006-06-11 |
| Find all providers in zip 83544 | ||||
| Taxonomy Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619360724 | Charolais Care Viii, Inc | Psychiatric Hospital | 650 Addison Ave W Ste 300b, Twin Falls, ID 83301-5851 | 2015-03-13 |
| 1710072046 | Helping Hands Sanctuary of Idaho | Psychiatric Hospital | 500 Polk St E, Kimberly, ID 83341 | 2006-10-03 |
| 1275504896 | Beacon Health Services Inc | Psychiatric Hospital | 1200 Hospital Way, Pocatello, ID 83201-2708 | 2006-01-31 |
| 1992789101 | State of Idaho Department of Health and Welfare | Psychiatric Hospital | 700 East Alice, Box 400, Blackfoot, ID 83221 | 2005-12-01 |
| 1437620358 | Lifeways, Inc | Psychiatric Hospital | 8050 W Northview St, Boise, ID 83704-7126 | 2018-12-17 |
| 1003397878 | Hbs of Meridian, LLC | Psychiatric Hospital | 2131 S Bonito Way, Meridian, ID 83642-1659 | 2018-08-28 |
| 1770977787 | Concordia Health Care Inc | Psychiatric Hospital | 1200 Hospital Way, Pocatello, ID 83201-2708 | 2015-03-27 |
| 1942643432 | Safe Haven Health Care Inc | Psychiatric Hospital | 8050 W Northview St, Boise, ID 83704-7126 | 2013-04-15 |
| 1780937532 | Dustin Sharpe | Psychiatric Hospital | 8050 W Northview St, Boise, ID 83704-7126 | 2012-10-17 |
| 1871800128 | Mountain View Center for Geriatric Psychiatry LLC | Psychiatric Hospital | 500 Polk St E, Kimberly, ID 83341-1618 | 2010-09-08 |
| 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.