Organization
COEUR D ALENE HOMES PHASE II
Active
Other names
Orchard Ridge Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY PETTIT (ADMINISTRATOR)
(208) 664-8119
Entity
Organization
Contact information
Practice address
624 W HARRISON AVE, COEUR D ALENE, ID 83814-5286
(208) 664-8119
(208) 292-2551
Mailing address
624 W HARRISON AVE, COEUR D ALENE, ID 83814-5286
(208) 664-8119
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M8075669
—
ID
Enumeration date
08/26/2020
Last updated
04/24/2025
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