MOSCOW OF OLYMPUS LLC
NPI 1689391161
Assisted Living Facility in Moscow, ID

Active since October 25, 2022CLIA 13D2287826 · Waiver
640 N EISENHOWER ST, MOSCOW, ID 83843(208) 401-9600(208) 314-0639 Get Directions Write a Review

NPPES record last updated: February 23, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 23, 2023, Oct 25, 2022 (2 updates tracked since 2022).

About Moscow Of Olympus Llc NPPES

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

MOSCOW OF OLYMPUS LLC (NPI 1689391161) is a healthcare organization registered as an assisted living facility in Moscow, Idaho and active in the NPI registry since October 2022. The organization holds a CLIA Waiver certificate valid through August 16, 2027 and lists Heather Baird, Assistant General Counsel, as its authorized official.

NPPES Registry Identity

NPI1689391161
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameMOSCOW OF OLYMPUS LLC
Location Address640 N EISENHOWER STMoscow, ID 83843-9588
Mailing Address2205 E Riverside Dr Ste 100Eagle, ID 83616-7621 · (208) 401-9600 · Fax (208) 314-0639
Fax(208) 314-0639
Organization SubpartNo
Authorized OfficialHeather BairdAssistant General Counsel · (208) 401-9600
Enumeration DateOctober 25, 2022
Last NPPES UpdateFebruary 23, 20232 updates tracked since enumeration
NPPES CertifiedFebruary 23, 2023
NPI 1689391161 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.

640 N EISENHOWER ST, Moscow, ID 83843

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 13D2287826

Moscow Of Olympus LLC · Moscow, ID
Active · expires Aug 16, 2027
CLIA Number13D2287826
Laboratory TypeAssisted Living Facility
Certificate Effective DateAugust 17, 2025
Certificate Expiration DateAugust 16, 2027
Laboratory DirectorEmma R. Andersen
Laboratory Phone(208) 882-6560
Laboratory LocationMoscow Of Olympus LLC640 N Eisenhower Street Alf, Moscow, ID 83843
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

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

Occupational Therapy Assistant
640 N EISENHOWER ST
MOSCOW, ID 83843
Assisted Living Facility
640 N EISENHOWER ST
MOSCOW, ID 83843
Occupational Therapist
640 N EISENHOWER ST
MOSCOW, ID 83843
Speech-Language Pathologist
640 N EISENHOWER ST
MOSCOW, ID 83843
Physical Therapy Assistant
640 N EISENHOWER ST
MOSCOW, ID 83843
Speech-Language Pathologist
640 N EISENHOWER ST
MOSCOW, ID 83843
Skilled Nursing Facility
640 N EISENHOWER ST
MOSCOW, ID 83843
Skilled Nursing Facility
640 N EISENHOWER ST
MOSCOW, ID 83843

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 Moscow Of Olympus LLC's NPI number?

The NPI number for Moscow Of Olympus LLC is 1689391161. It was assigned to this organization in the NPPES registry on October 25, 2022.

Where is Moscow Of Olympus LLC located?

Moscow Of Olympus LLC is located at 640 N Eisenhower St, Moscow, ID 83843. The listed phone number is (208) 401-9600.

What is Moscow Of Olympus LLC's specialty?

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

Does Moscow Of Olympus LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 13D2287826) is associated with this NPI, valid through August 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Moscow Of Olympus LLC was last updated on February 23, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.