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EDGEWOOD PLANTATION PLACE LLC
NPI 1023305497
Assisted Living Facility in Boise, ID

Active since July 06, 2011
3921 KESSINGER LN, BOISE, ID 83703(208) 853-7300(208) 853-9328 Get Directions Write a Review

NPPES record last updated: August 18, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Edgewood Plantation Place Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDGEWOOD PLANTATION PLACE LLC (NPI 1023305497) is a healthcare organization registered as an assisted living facility in Boise, Idaho and active in the NPI registry since July 2011. The organization lists John Dybwad, Vp Of Finance, as its authorized official.

NPPES Registry Identity

NPI1023305497
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameEDGEWOOD PLANTATION PLACE LLC
Location Address3921 KESSINGER LNBoise, ID 83703-3003
Mailing AddressPo Box 13238Grand Forks, ND 58208 · (701) 738-2000 · Fax (208) 853-9328
Phone(208) 853-7300
Fax(208) 853-9328
Organization SubpartNo
Authorized OfficialJohn DybwadVp Of Finance · (701) 757-5422
Enumeration DateJuly 6, 2011
Last NPPES UpdateAugust 18, 2022
NPPES CertifiedAugust 18, 2022
✔ NPI 1023305497 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in ID · 83703
Definition

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.

3921 KESSINGER LN, Boise, ID 83703
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Other Identifiers 1

MedicaidA0000774ID

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edgewood Plantation Place LLC's NPI number?

The NPI number for Edgewood Plantation Place LLC is 1023305497. It was assigned to this organization in the NPPES registry on July 6, 2011.

Where is Edgewood Plantation Place LLC located?

Edgewood Plantation Place LLC is located at 3921 Kessinger Ln, Boise, ID 83703. The listed phone number is (208) 853-7300.

What is Edgewood Plantation Place LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Edgewood Plantation Place LLC was last updated on August 18, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.