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General NPI Number Information
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NPI Number | 1124903232
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Entity Type | Organization
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Legal Business Name | ORCHARD PRAIRIE HEALTHCARE LLC
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 1701 N 3RD ST
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City | COEUR D ALENE
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State | ID
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Zip | 83814-3404
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Country | US
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Telephone | 509-210-3741
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 N 3RD ST
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City | COEUR D ALENE
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State | ID
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Zip | 83814-3404
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | AMBER L TUELLER
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Credential |
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Telephone | 208-207-2726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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