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IDAHO DEPT OF HEALTH & WELFARE REG 1 CMH PSR CDA
NPI 1164550455
Clinic/Center - Rehabilitation in Coeur D Alene, ID

Active since March 01, 2007
1250 IRONWOOD DR STE 100, COEUR D ALENE, ID 83814(208) 769-1515(208) 666-6744 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Idaho Dept Of Health & Welfare Reg 1 Cmh Psr Cda NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IDAHO DEPT OF HEALTH & WELFARE REG 1 CMH PSR CDA (NPI 1164550455) is a healthcare organization registered as a rehabilitation in Coeur D Alene, Idaho and active in the NPI registry since March 2007. The organization lists Cora Jo Gussenhoven, Program Manager, as its authorized official.

NPPES Registry Identity

NPI1164550455
Entity TypeOrganization
Primary Taxonomy261QR0400X
Legal Business NameIDAHO DEPT OF HEALTH & WELFARE REG 1 CMH PSR CDA
Location Address1250 IRONWOOD DR STE 100Coeur D Alene, ID 83814-2628
Mailing Address1250 Ironwood Dr Ste 100Coeur D Alene, ID 83814-2628 · (208) 769-1515 · Fax (208) 666-6744
Phone(208) 769-1515
Fax(208) 666-6744
Organization SubpartNo
Authorized OfficialCora Jo GussenhovenProgram Manager · (208) 769-1406
Enumeration DateMarch 1, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1164550455 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · RehabilitationAmbulatory Health Care Facilities
Taxonomy Code261QR0400X
1250 IRONWOOD DR STE 100, Coeur D Alene, ID 83814
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Other Identifiers 3

OtherHW199Blue Cross Of Idaho
Medicaid0028408ID
Other000010018348Blue Shield

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Idaho Dept Of Health & Welfare Reg 1 Cmh Psr Cda's NPI number?

The NPI number for Idaho Dept Of Health & Welfare Reg 1 Cmh Psr Cda is 1164550455. It was assigned to this organization in the NPPES registry on March 1, 2007.

Where is Idaho Dept Of Health & Welfare Reg 1 Cmh Psr Cda located?

Idaho Dept Of Health & Welfare Reg 1 Cmh Psr Cda is located at 1250 Ironwood Dr Ste 100, Coeur D Alene, ID 83814. The listed phone number is (208) 769-1515.

What is Idaho Dept Of Health & Welfare Reg 1 Cmh Psr Cda's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, with taxonomy code 261QR0400X.

When was this NPI record last updated?

The NPPES record for Idaho Dept Of Health & Welfare Reg 1 Cmh Psr Cda was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.