EDGEWOOD SPRING CREEK EAGLE ISLAND LLC (NPI# 1114383577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114383577 |
| Entity Type | Organization |
| Organization Name | EDGEWOOD SPRING CREEK EAGLE ISLAND LLC |
| Practice Address |
12426 W Explorer Dr Ste 220 Boise ID 83713-1560 |
| Mailing Address |
77 N Fisher Park Way Eagle ID 83616 |
| Practice Telephone | 2089474012 |
| Mailing Telephone | 2089396499 |
| Enumeration Date | 2016-01-14 |
| Last Update Date | 2016-01-14 |
| Authorized Official Name | ASHLEY TAYLOR (CONTROLLER) |
| Authorized Official Telephone | 2089474012 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | RC1104 | ID | Nursing & Custodial Care Facilities |
| Street Address |
12426 W EXPLORER DR STE 220 |
| City | BOISE |
| State | ID |
| Zip Code | 83713-1560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265902332 | Kidscare Home Health of Idaho, LLC | Home Health | 1835 Wildwood Street, Boise, ID 83713 | 2018-11-30 |
| 1417463928 | Kimberly Ann Bohrer | Behavioral Analyst | 12053 W Hickory Dr, Boise, ID 83713 | 2017-12-19 |
| 1407371891 | Emir Hadzic | Optometrist | 13239 W. Fernleaf St., Boise, ID 83713 | 2017-08-07 |
| 1518336650 | Alliance Physical Medicine | Nurse Practitioner | 13909 W Wainwright Drive, Boise, ID 83713 | 2015-09-18 |
| 1083038335 | Jan L Rehder | Nurse Practitioner | 13150 W Persimmon Lane, Boise, ID 83713 | 2014-02-06 |
| 1508287061 | Heather N Fox | Physician Assistant | 12273 West Mcmillan Road, Boise, ID 83713 | 2013-12-30 |
| 1659667459 | Jayson Clark | Dentist | 4274 N Eagle Road, Boise, ID 83713 | 2011-06-21 |
| 1043503659 | Steven Anthony Eckhoff | Physician Assistant | 11662 W Arlen St, Boise, ID 83713 | 2011-05-16 |
| 1790923621 | Christie Dudash Flynn | Physician Assistant | 12273 W Mcmillian Road, Boise, ID 83713 | 2009-01-30 |
| 1699930404 | Dennis J. Garpetti, Dds, P.C. | Dentist | 13108 West Persimmon Lane, Boise, ID 83713 | 2008-07-21 |
| Find all providers in zip 83713 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619593068 | Frontier Management, LLC | Assisted Living Facility | 10250 W Smoke Ranch Dr, Boise, ID 83709-1467 | 2020-06-22 |
| 1164046413 | Grace Memory Care At State Street LLC | Assisted Living Facility | 9779 W State St, Boise, ID 83714-1638 | 2020-06-02 |
| 1356965693 | Grace At State Street LLC | Assisted Living Facility | 9995 W State St, Boise, ID 83714-1636 | 2020-06-02 |
| 1447874797 | Grace At Englefield Green LLC | Assisted Living Facility | 250 S Allumbaugh Way, Boise, ID 83709-5624 | 2020-06-02 |
| 1942848502 | The Spaulding Home LLC | Assisted Living Facility | 1709 W Spaulding St, Boise, ID 83705-4223 | 2019-12-13 |
| 1023671435 | Edgewood Castle Hills LLC | Assisted Living Facility | 5955 W Castle Dr, Boise, ID 83703-3215 | 2019-04-22 |
| 1477016012 | Veranda At Barber Station LLC | Assisted Living Facility | 3266 E. Barber Valley Drive, Boise, ID 83712 | 2019-04-10 |
| 1568843605 | Treasure Valley Senior Living, Inc. | Assisted Living Facility | 1777 S Curtis Rd, Boise, ID 83705-2708 | 2015-06-15 |
| 1083959902 | Brookdale Senior Living Communities, Inc. | Assisted Living Facility | 739 E Parkcenter Blvd, Boise, ID 83706-6511 | 2012-12-04 |
| 1821366998 | Bronco Senior Services | Assisted Living Facility | 1093 S Hilton St, Boise, ID 83705-1971 | 2011-12-05 |
| Find all providers in BOISE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.