| Lifehouse Healthcare | |
|
212 S 11th St Ste 1 Coeur D Alene ID 83814-4000 | |
| (208) 243-9395 | |
| (951) 466-2426 |
| Full Name | Lifehouse Healthcare |
|---|---|
| Speciality | Clinic/Center |
| Location | 212 S 11th St Ste 1, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Carlo R Orozco (SOLE MEMBER) |
| Authorized Official Contact | 2082439395 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifehouse Healthcare 212 S 11th St Ste 1 Coeur D Alene ID 83814-4000 Ph: (208) 667-3113 | Lifehouse Healthcare 212 S 11th St Ste 1 Coeur D Alene ID 83814-4000 Ph: (208) 243-9395 |
| NPI Number | 1467142315 |
|---|---|
| Provider Enumeration Date | 05/12/2023 |
| Last Update Date | 11/01/2023 |
| Medicare PECOS PAC ID | 2062872625 |
|---|---|
| Medicare Enrollment ID | O20230714002054 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467142315 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Laura Elaine Cartwright |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457664294 PECOS PAC ID: 7113173451 Enrollment ID: I20120802000070 |
| Provider Name | Kimberly Lynn Shelden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083143382 PECOS PAC ID: 9638503733 Enrollment ID: I20191226000465 |
| Provider Name | Carlo Roberto Orozco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386091676 PECOS PAC ID: 6608152921 Enrollment ID: I20201104001780 |
| Provider Name | Amanda Diane Cipriani |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194120758 PECOS PAC ID: 8325386758 Enrollment ID: I20211214001316 |
| Provider Name | Leila Richelle Hepp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356642672 PECOS PAC ID: 3779765839 Enrollment ID: I20230620000803 |
| Provider Name | Brad Richard Smedley |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1356726145 PECOS PAC ID: 4688033822 Enrollment ID: I20240115000564 |
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