{
  "npi": "1316660467",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "MPC",
    "authorized_official_first_name": "JASON",
    "authorized_official_last_name": "COOMBS",
    "authorized_official_middle_name": "D",
    "authorized_official_telephone_number": "8013501716",
    "authorized_official_title_or_position": "CEO/Founder",
    "certification_date": "2025-07-17",
    "enumeration_date": "2022-09-23",
    "last_updated": "2025-07-23",
    "organization_name": "BRICK HOUSE RECOVERY - COEUR D'ALENE GOP",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "3918 N SCHREIBER WAY STE B",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "COEUR D ALENE",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "838158395",
      "state": "ID",
      "telephone_number": "801-350-1716"
    },
    {
      "address_1": "4727 N HIGH PRAIRIE PL",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "STAR",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "208-286-4292",
      "postal_code": "836695371",
      "state": "ID",
      "telephone_number": "801-350-1716"
    }
  ],
  "taxonomies": [
    {
      "code": "251J00000X",
      "desc": "Nursing Care",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "261QM0850X",
      "desc": "Clinic/Center, Adult Mental Health",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "324500000X",
      "desc": "Substance Abuse Rehabilitation Facility",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "251S00000X",
      "desc": "Community/Behavioral Health",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Community/Behavioral Health",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": []
  }
}