NPI: 1306459599 · COEUR D ALENE, ID 83814 · Assisted Living Facility · NPI assigned 08/26/2020
| Authorized Official | PETTIT, TIFFANY (ADMINISTRATOR) |
| NPI Enumeration Date | 08/26/2020 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 16 | $34K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| S5140 | Foster care, adult; per diem | 16 | 14 | $34K |