GRITMAN MEDICAL CENTER INC (NPI# 1871708289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871708289 |
| Entity Type | Organization |
| Organization Name | GRITMAN MEDICAL CENTER INC |
| Other Organization Name | GRITMAN CHILD CARE SERVICES |
| Practice Address |
324 S Cleveland St Moscow ID 83843-3768 |
| Mailing Address |
700 S Main St Moscow ID 83843-3056 |
| Practice Telephone | 2088836024 |
| Mailing Telephone | 2088824511 |
| Mailing Fax Number | 2088836580 |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JEFFERY MARTIN (CEO) |
| Authorized Official Telephone | 2088824511 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | DC200706 | ID | Agencies |
| Other Name | Type Code |
|---|---|
| GRITMAN CHILD CARE SERVICES | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356438816 | Gritman Medical Center Inc | Clinic/Center | 156 6th St, Potlatch, ID 83855 | 2006-10-06 |
| 1013556596 | Gritman Medical Center Inc | Pain Medicine | 804 S Washington St Ste A, Moscow, ID 83843-3182 | 2019-12-31 |
| 1932769700 | Gritman Medical Center Inc | Internal Medicine | 700 S Main St, Moscow, ID 83843-3046 | 2019-06-14 |
| 1235626474 | Gritman Medical Center Inc | Psychiatry & Neurology | 803 S Main St Ste 210, Moscow, ID 83843-2695 | 2018-04-13 |
| 1235680703 | Gritman Medical Center Inc | Internal Medicine | 804 S Washington St Ste A, Moscow, ID 83843-3182 | 2016-10-20 |
| 1477004828 | Gritman Medical Center Inc | General Practice | 412 S Main St, Troy, ID 83871 | 2016-10-20 |
| 1386041119 | Gritman Medical Center Inc | Skilled Nursing Facility | 700 S Main St, Moscow, ID 83843-3056 | 2014-11-21 |
| 1942567847 | Gritman Medical Center Inc | Physician Assistant | 412 S Main St, Troy, ID 83871-0415 | 2012-04-16 |
| 1750475380 | Gritman Medical Center Inc | Clinic/Center | 606 E Main St, Kendrick, ID 83537 | 2006-10-03 |
| 1619988144 | Gritman Medical Center Inc | General Acute Care Hospital | 700 S Main St, Moscow, ID 83843-3056 | 2006-08-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | GRITMAN MEDICAL CENTER INC. | 700 S Main St, Moscow, ID 83843 |
| Street Address |
324 S CLEVELAND ST |
| City | MOSCOW |
| State | ID |
| Zip Code | 83843-3768 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033726880 | Moscow Physical Therapy, LLC | Clinic/Center | 1174 Alturas Drive, Suite 2, Moscow, ID 83843 | 2020-09-25 |
| 1831703057 | Hydee Flishaw Tubbs Becker | Dietitian, Registered | 614 North Hayes Street, Moscow, ID 83843 | 2020-09-04 |
| 1528626959 | Ryan Steven Clark | Student in an Organized Health Care Education/Training Program | 212 Farm Road, #201, Moscow, ID 83843 | 2019-05-31 |
| 1770141384 | Lingwen Zhang | Specialist/Technologist | 901 Paradise Creek Rd, Moscow, ID 83843 | 2019-05-30 |
| 1306363478 | Elizabeth Campbell | Dietitian, Registered | 611 S. Main, Moscow, ID 83843 | 2017-08-29 |
| 1598285496 | Gina Cretser | Counselor | 212 Rodeo Dr. #410, Moscow, ID 83843 | 2017-06-21 |
| 1124558721 | Morgan Leigh Derloshon | Specialist/Technologist | 275 Southview Ave, Apt 206, Moscow, ID 83843 | 2017-06-15 |
| 1619411790 | Kaylene Howard | Massage Therapist | 127 South Washington, Suite 6, Moscow, ID 83843 | 2016-12-08 |
| 1407237043 | Jacob Kent Christensen | Family Medicine | 831 S Ash St, Moscow, ID 83843 | 2015-06-09 |
| 1366851388 | Elisabeth Henry | Pharmacist | 2740 West Pullman Rd, Moscow, ID 83843 | 2014-08-04 |
| Find all providers in zip 83843 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558482711 | C and R Incorporation | Day Training, Developmentally Disabled Services | 1107 S Logan St, Moscow, ID 83843-3124 | 2007-04-03 |
| 1073790309 | C and R Inc. | Day Training, Developmentally Disabled Services | 1107 S Logan St, Moscow, ID 83843-3124 | 2008-01-29 |
| 1487869798 | Inclusion North, Inc. | Day Training, Developmentally Disabled Services | 213 N Main St, Suite #1, Moscow, ID 83843-2700 | 2007-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477086114 | Teton Supported Living LLC | Day Training, Developmentally Disabled Services | 4101 N Creswell Way, Boise, ID 83713-2404 | 2017-04-10 |
| 1962889055 | Community Connections South Central | Day Training, Developmentally Disabled Services | 212 2nd Ave W, #102 & 104, Twin Falls, ID 83301-6016 | 2015-04-28 |
| 1154714897 | Phoenix Management LLC | Day Training, Developmentally Disabled Services | 10991 Deerridge Dr., Chubbuck, ID 83202 | 2015-03-05 |
| 1902205230 | Andrea Loban | Day Training, Developmentally Disabled Services | 5049 Fox Creek Hollow, Victor, ID 83455-0000 | 2014-08-22 |
| 1336570118 | Independent Living Specialists, LLC | Day Training, Developmentally Disabled Services | 379 Yellowstone Ave, Pocatello, ID 83201-4529 | 2013-12-04 |
| 1871935064 | Community Connections North, Inc. | Day Training, Developmentally Disabled Services | 1230 N Northwood Center Ct, Suite A, Coeur D Alene, ID 83814-4941 | 2013-07-29 |
| 1851734107 | Foundations for Independence LLC | Day Training, Developmentally Disabled Services | 2316 N Cole Rd Ste C, Boise, ID 83704-7365 | 2013-04-16 |
| 1679816912 | A New Hope, LLC | Day Training, Developmentally Disabled Services | 19b Mountain Dr, Pocatello, ID 83204 | 2013-04-05 |
| 1457694176 | A Plus Solutions Center | Day Training, Developmentally Disabled Services | 2311 Park Ave, Unit 3, Suite 12, Burley, ID 83318-2104 | 2013-04-01 |
| 1518208966 | Learning Garden Developmental Preschool | Day Training, Developmentally Disabled Services | 412 E Mullan Ave, Post Falls, ID 83854-7641 | 2013-03-11 |
| 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.