WILKINSON GEORGIA IDAHO SENIOR HOUSING LLC (NPI# 1700078524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700078524 |
| Entity Type | Organization |
| Organization Name | WILKINSON GEORGIA IDAHO SENIOR HOUSING LLC |
| Other Organization Name | FOUR SEASONS ASSITED LIVING |
| Practice Address |
840 E Dalton Ave Coeur D Alene ID 83815-9338 |
| Mailing Address |
78 Centennial Loop Eugene OR 97401-7900 |
| Practice Telephone | 2086652100 |
| Practice Fax Number | 2086659250 |
| Mailing Telephone | 5414743373 |
| Mailing Fax Number | 5417465781 |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2008-06-19 |
| Authorized Official Name | MR. JOHN HOLTZ (CONTROLLER) |
| Authorized Official Telephone | 5417473373 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305S00000X | Point of Service | Managed Care Organizations |
| Other Name | Type Code |
|---|---|
| FOUR SEASONS ASSITED LIVING | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336332469 | Wilkinson Georgia Idaho Senior Housing LLC | Assisted Living Facility | 11725 Pointe Pl, Roswell, GA 30076-4636 | 2007-08-22 |
| 1700079829 | Wilkinson Georgia Idaho Senior Housing LLC | Assisted Living Facility | 4484 N Shallowford Rd, Dunwoody, GA 30338-6402 | 2007-08-22 |
| Street Address |
840 E DALTON AVE |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83815-9338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568972016 | Etros Living, LLC | Alzheimer Center (Dementia Center) | 840 E Dalton Ave, Coeur D Alene, ID 83815-9338 | 2017-10-10 |
| 1326473877 | Pacifica L 44 LLC | Assisted Living Facility | 840 E Dalton Ave, Coeur D Alene, ID 83815-9338 | 2013-09-03 |
| 1164869079 | Encore Senior Living, LLC | Assisted Living Facility | 840 E Dalton Ave, Coeur D Alene, ID 83815-9338 | 2013-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790133163 | Christine Lee Stanton | Speech-Language Pathologist | 3825 N. Blalock Drive, Coeur D'alene, ID 83815 | 2016-05-26 |
| 1578921961 | Kayla Wearne | Speech-Language Pathologist | 917 W Canfield Avenue, Coeur D'alene, ID 83815 | 2016-02-01 |
| 1770954794 | William Strong | Speech-Language Pathologist | 3902 Broken Arrow Rd, Coeur D Alene, ID 83815 | 2015-10-16 |
| 1235517079 | Denny Bordeaux | Emergency Medical Technician, Paramedic | 7294 Downing Lane, Coeur D Alene, ID 83815 | 2015-05-13 |
| 1689075657 | Barbara Campbell | Pharmacist | W 201 Neider Rd., Coeur D'alene, ID 83815 | 2014-09-10 |
| 1710313671 | Sean Cooper | Pharmacist | W. 201 Neider Rd., Coeur D' Alene, ID 83815 | 2013-09-23 |
| 1275871329 | Lake City Dental | Dentist | 6176 Government Way, Coeur D'alene, ID 83815 | 2013-01-24 |
| 1881972701 | A Better Personal Care Inc | In Home Supportive Care | 3115 N Government Way Ste 2, Coeur D'alene, ID 83815 | 2011-07-26 |
| 1013206895 | Robert Sperry | Pharmacist | 41650 W Maricopacg Hwy., Maricopa, AZ 83815 | 2011-04-01 |
| 1629304670 | Marciea W. Buckley | Social Worker | 109 Harrison Ave, Coeur D' Alene, ID 83815 | 2009-10-27 |
| Find all providers in zip 83815 | ||||
| Taxonomy Code | 305S00000X |
| Grouping | Managed Care Organizations |
| Classification | Point of Service |
| This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |
| Notes: Source: "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. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740661388 | Loftus Family Dental | Point of Service | 2615 N Fruitland Ln, Coeur D Alene, ID 83815-7914 | 2015-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417442484 | Corbett Sousa | Point of Service | 16 12th Ave S Ste 208, Nampa, ID 83651-3937 | 2018-06-22 |
| 1326565516 | Practice Pros Inc | Point of Service | 2674 N Arrowwood Way, Meridian, ID 83646-4406 | 2017-08-28 |
| 1679026447 | Kimberly Drewrey, Aprn, Np-c | Point of Service | 5210 Cleveland Blvd, Suite 140 #344, Caldwell, ID 83607-1796 | 2016-07-28 |
| 1063839124 | City of Blackfoot | Point of Service | 960 S Fisher Ave, Blackfoot, ID 83221-3370 | 2014-03-26 |
| 1487823886 | Bonaventure Place Retirement & Assisted Living Community | Point of Service | 5850 N Five Mile Rd, Boise, ID 83713-5466 | 2008-02-29 |
| 1689855173 | Maximum Security Inc | Point of Service | 357 W Center St, Suite 212, Pocatello, ID 83204-3236 | 2007-11-26 |
| 1437208899 | Hisway, LLC | Point of Service | 348 N Orchard St, Boise, ID 83706-1627 | 2007-01-08 |
| 1083660021 | Cherry Lane Dental | Point of Service | 1104 W Cherry Ln, Meridian, ID 83642-1513 | 2006-05-25 |
| 1154718740 | Siena Einerprises, LLC | Point of Service | 667 E Grouse Ct, Meridian, ID 83646-4414 | 2015-04-21 |
| 1831468651 | Crump Enterprises | Point of Service | 11311 W Chinden Blvd, Boise, ID 83714-1021 | 2011-12-22 |
| Find all providers with the same taxonomy | ||||
| City | COEUR D ALENE |
| Zip Code | 83815 |
Please comment or provide details below to improve the information on WILKINSON GEORGIA IDAHO SENIOR HOUSING LLC.
| 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.