NPI 1306459599

Coeur D Alene Homes Phase II

Organisation Assisted Living Facility Coeur D Alene, ID

Practice location

Address: 624 W Harrison Ave, Coeur D Alene, ID 83814-5286
Phone: (208) 664-8119
Fax: (208) 292-2551

Authorised official

Name: Tiffany Pettit
Title: Administrator
Phone: (208) 664-8119

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X

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Registry record

NPI: 1306459599
Entity type: Organization
NPI issued: 26 Aug 2020
Record last updated: 24 Apr 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.