# 5 CODES PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114845526
- **Authorized official:** STACEY HEIDT (OPERATIONS MANAGER)
- **Authorized official phone:** (509) 998-3331

## Contact information

- **Practice address:** 1831 N LAKEWOOD DR STE 1, COEUR D ALENE, ID 83814-2669
- **Practice address phone:** (208) 215-7199
- **Practice address fax:** (208) 215-7199
- **Mailing address:** 1831 N LAKEWOOD DR STE 1, COEUR D ALENE, ID 83814-2669
- **Mailing address phone:** (208) 215-7199
- **Mailing address fax:** (208) 215-7199

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/06/2026
- **Last updated:** 07/06/2026