OrganizationActive
Idaho Dept of Health & Welfare Reg 1 Cmh Psr Cda
NPI 1164550455 · Rehabilitation Clinic/Center · Coeur D Alene, ID
Provider details
- NPI number
- 1164550455
- Entity type
- Organization
- Primary specialty
- Rehabilitation Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Cora Jo Gussenhoven, Program Manager(208) 769-1406
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1250 Ironwood Dr Ste 100
Coeur D Alene, ID 83814-2628
Phone: (208) 769-1515
Fax: (208) 666-6744
Street-level locationGet directions
Mailing address
1250 Ironwood Dr Ste 100
Coeur D Alene, ID 83814-2628
Registry dates
- Enumerated
- 2007-03-01
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.