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General NPI Number Information
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NPI Number | 1760730196
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Entity Type | Organization
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Legal Business Name | COORDINATED SERVICES OF IDAHO, LLC
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 1111 E SHERMAN AVE
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City | COEUR D ALENE
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State | ID
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Zip | 83814-4154
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Country | US
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Telephone | 208-660-9534
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Fax | 208-665-5795
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Provider Business Mailing Address
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Address Line | 301 S WIDE RIVER RD
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City | POST FALLS
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State | ID
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Zip | 83854-7011
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Country | US
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Telephone | 208-660-9534
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Fax | 208-665-5795
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Authorized Official
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Title or Position | QWNER
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Name | ALESSANDRA BERTOZZI BILLINGSLEA
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Credential | M.ED.
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Telephone | 208-660-9534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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