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EDGEWOOD CASTLE HILLS LLC
NPI 1023671435
Assisted Living Facility in Boise, ID

Active since April 22, 2019CLIA 13D2195041 · Waiver
5955 W CASTLE DR, BOISE, ID 83703(208) 510-9047 Get Directions Write a Review

NPPES record last updated: August 18, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 18, 2022, Apr 22, 2019 (2 updates tracked since 2019).

About Edgewood Castle Hills Llc NPPES

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

EDGEWOOD CASTLE HILLS LLC (NPI 1023671435) is a healthcare organization registered as an assisted living facility in Boise, Idaho and active in the NPI registry since April 2019. The organization holds a CLIA Waiver certificate valid through October 5, 2026 and lists John Dybwad, Vp Of Finance, as its authorized official.

NPPES Registry Identity

NPI1023671435
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameEDGEWOOD CASTLE HILLS LLC
Location Address5955 W CASTLE DRBoise, ID 83703-3215
Mailing AddressPo Box 13238Grand Forks, ND 58208-3238 · (701) 738-2000
Phone(208) 510-9047
Organization SubpartNo
Authorized OfficialJohn DybwadVp Of Finance · (701) 757-5422
Enumeration DateApril 22, 2019
Last NPPES UpdateAugust 18, 20222 updates tracked since enumeration
NPPES CertifiedAugust 18, 2022
✔ NPI 1023671435 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
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.
5955 W CASTLE DR, Boise, ID 83703
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 13D2195041

Edgewood Castle Hills LLC · Boise, ID
Active · expires Oct 5, 2026
CLIA Number13D2195041
Laboratory TypeAssisted Living Facility
Certificate Effective DateOctober 6, 2024
Certificate Expiration DateOctober 5, 2026
Laboratory DirectorLisa Perredoud
Laboratory Phone(208) 331-1300
Laboratory LocationEdgewood Castle Hills LLC5955 Castle Dr, Boise, ID 83703
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SARAH VELA
Peer Specialist
5955 W CASTLE DR
BOISE, ID 83703
Ada County (208) 510-9047

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 Castle Hills LLC's NPI number?

The NPI number for Edgewood Castle Hills LLC is 1023671435. It was assigned to this organization in the NPPES registry on April 22, 2019.

Where is Edgewood Castle Hills LLC located?

Edgewood Castle Hills LLC is located at 5955 W Castle Dr, Boise, ID 83703. The listed phone number is (208) 510-9047.

What is Edgewood Castle Hills LLC's specialty?

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

Does Edgewood Castle Hills LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 13D2195041) is associated with this NPI, valid through October 5, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Edgewood Castle Hills LLC was last updated on August 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.