Organization
BRICK HOUSE RECOVERY - COEUR D'ALENE GOP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON D COOMBS MPC (CEO/FOUNDER)
(801) 350-1716
Entity
Organization
Contact information
Practice address
3918 N SCHREIBER WAY STE B, COEUR D ALENE, ID 83815-8395
(801) 350-1716
Mailing address
4727 N HIGH PRAIRIE PL, STAR, ID 83669-5371
(801) 350-1716
(208) 286-4292
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1477276194
NPI COEUR D'ALENE
ID
Enumeration date
09/23/2022
Last updated
07/23/2025
Update your record
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