BROOKDALE COEUR D'ALENE
NPI 1609088525
Assisted Living Facility in Coeur D Alene, ID

Active since May 04, 2007CLIA 13D2201173 · Waiver
205 E ANTON AVE, COEUR D ALENE, ID 83815(208) 667-6490(208) 765-4352 Get Directions Write a Review

NPPES record last updated: July 20, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 20, 2020, May 16, 2016 (2 updates tracked since 2016).

  • Organization
  • Assisted Living Facility
  • CLIA Number: 13D2201173
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 11-18-2026

About BROOKDALE COEUR D'ALENE

This page provides the complete NPI Profile along with additional information for Brookdale Coeur D'alene, a provider established in Coeur D Alene, Idaho operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1609088525 assigned on May 2007. The practitioner's primary taxonomy code is 310400000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Brookdale Coeur D'alene. The authorized official of this NPI record is Joanne K Leskowicz (Senior Vice President)

NPI
1609088525 Verify this NPI
Provider Legal Name
EMERITUS CORPORATION
Other Organization Name
BROOKDALE COEUR D'ALENE
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
205 E ANTON AVE COEUR D ALENE, ID 83815
Location Phone
(208) 667-6490
Location Fax
(208) 765-4352
Mailing Address
6737 W WASHINGTON ST SUITE 2300 MILWAUKEE, WI 53214
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
05-04-2007
Last Update Date
07-20-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JOANNE K LESKOWICZ

Authorized Official Title
SENIOR VICE PRESIDENT
Authorized Official Phone
(414) 918-5000

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
M8055838MEDICAID (05)ID 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
13D2201173
Facility Type
Assisted Living Facility
Certificate Effective Date
November 19, 2024
Certificate Expiration Date
November 18, 2026
Laboratory Director
DAHNA GATES
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Brookdale Coeur D'alene to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for BROOKDALE COEUR D'ALENE

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1609088525, enumerated as an "organization" on May 04, 2007.

The provider is located at 205 E ANTON AVE COEUR D ALENE, ID 83815 and the phone number is (208) 667-6490.

Assisted Living Facility with taxonomy code 310400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.