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EDGEWOOD SPRING CREEK SODA SPRINGS, LLC
NPI 1841575982
Assisted Living Facility in Soda Springs, ID

Active since October 20, 2011
425 S SPRING CREEK DR, SODA SPRINGS, ID 83276(208) 547-0257(208) 547-4879 Get Directions Write a Review

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

About Edgewood Spring Creek Soda Springs, Llc NPPES

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

EDGEWOOD SPRING CREEK SODA SPRINGS, LLC (NPI 1841575982) is a healthcare organization registered as an assisted living facility in Soda Springs, Idaho and active in the NPI registry since October 2011. The organization lists John Dybwad, Vp Of Finance, as its authorized official.

NPPES Registry Identity

NPI1841575982
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameEDGEWOOD SPRING CREEK SODA SPRINGS, LLC
Location Address425 S SPRING CREEK DRSoda Springs, ID 83276-1628
Mailing AddressPo Box 13238Grand Forks, ND 58208 · (701) 738-2000 · Fax (208) 350-6761
Phone(208) 547-0257
Fax(208) 547-4879
Organization SubpartNo
Authorized OfficialJohn DybwadVp Of Finance · (701) 757-5422
Enumeration DateOctober 20, 2011
Last NPPES UpdateAugust 19, 2022
NPPES CertifiedAugust 19, 2022
✔ NPI 1841575982 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 · RC-1010
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.
425 S SPRING CREEK DR, Soda Springs, ID 83276
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Other Providers at the Same Location NPPES

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

HERITAGE OF SODA SPRINGS LLC
Assisted Living Facility
425 S SPRING CREEK DR
SODA SPRINGS, ID 83276
Caribou County (208) 547-0257

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 Soda Springs, LLC's NPI number?

The NPI number for Edgewood Spring Creek Soda Springs, LLC is 1841575982. It was assigned to this organization in the NPPES registry on October 20, 2011.

Where is Edgewood Spring Creek Soda Springs, LLC located?

Edgewood Spring Creek Soda Springs, LLC is located at 425 S Spring Creek Dr, Soda Springs, ID 83276. The listed phone number is (208) 547-0257.

What is Edgewood Spring Creek Soda Springs, 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 Soda Springs, 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 3 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.