Edgewood Plantation Place Llc

LBN: Edgewood Plantation Place Llc
Edgewood Plantation Place Llc is an health care organization with primary practice located at 3921 Kessinger Ln , Boise ID 83703-3003. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. Edgewood Plantation Place Llc can be contacted via phone (208) 853-7300, or through Dybwad, John via phone (701) 757-5422.

Contact Information

Primary practice address
3921 Kessinger Ln Boise ID 83703-3003
Phone: (208) 853-7300
Fax: (208) 853-9328
Website:
Map and Directions
Authorized official contact:
Name: Dybwad, John
Phone: (701) 757-5422

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X 83703 Idaho

Profile Details

NPI number 1023305497
LBN Legal business name Edgewood Plantation Place Llc
DBA Doing business as
Authorized official Dybwad, John
Entity Organization
Organization subpart 1 No
Enumeration date Jul 6th, 2011
Last updated Aug 18th, 2022 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023305497 NPPES
Idaho MEDICAID A0000774

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