EDGEWOOD SPRING CREEK EAGLE ISLAND LLC
NPI 1114383577
Assisted Living Facility in Boise, ID

Q: What is Edgewood Spring Creek Eagle Island LLC's specialty?

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

Active since January 14, 2016

12426 W EXPLORER DR STE 220, BOISE, ID 83713(208) 947-4012 Get Directions Write a Review

NPPES record last updated: August 19, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 19, 2022, Jan 14, 2016 (2 updates tracked since 2016).

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About Edgewood Spring Creek Eagle Island Llc NPPES

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

EDGEWOOD SPRING CREEK EAGLE ISLAND LLC (NPI 1114383577) is a healthcare organization registered as an assisted living facility in Boise, Idaho and active in the NPI registry since January 2016. The organization lists John Dybwad, Vp Of Finance, as its authorized official.

NPPES Registry Identity

NPI1114383577

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameEDGEWOOD SPRING CREEK EAGLE ISLAND LLC

Location Address12426 W EXPLORER DR STE 220Boise, ID 83713-1560

Mailing AddressPo Box 13238Grand Forks, ND 58208 · (701) 738-2000

Phone(208) 947-4012

Organization SubpartNo

Authorized OfficialJohn DybwadVp Of Finance · (701) 757-5422

Enumeration DateJanuary 14, 2016

Last NPPES UpdateAugust 19, 20222 updates tracked since enumeration

NPPES CertifiedAugust 19, 2022

✔ NPI 1114383577 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 · RC1104

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.

12426 W EXPLORER DR STE 220, Boise, ID 83713

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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 Spring Creek Eagle Island LLC's NPI number?

The NPI number for Edgewood Spring Creek Eagle Island LLC is 1114383577. It was assigned to this organization in the NPPES registry on January 14, 2016.

Where is Edgewood Spring Creek Eagle Island LLC located?

Edgewood Spring Creek Eagle Island LLC is located at 12426 W Explorer Dr Ste 220, Boise, ID 83713. The listed phone number is (208) 947-4012.

What is Edgewood Spring Creek Eagle Island 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 Spring Creek Eagle Island LLC was last updated on August 19, 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.