EDGEWOOD SPRING CREEK BOISE, LLC
NPI 1871876789
Assisted Living Facility in Boise, ID

Active since September 27, 2011
10681 MCMILLAN RD, BOISE, ID 83713(208) 954-5660 Get Directions Write a Review

NPPES record last updated: August 19, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Edgewood Spring Creek Boise, Llc NPPES

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

EDGEWOOD SPRING CREEK BOISE, LLC (NPI 1871876789) is a healthcare organization registered as an assisted living facility in Boise, Idaho and active in the NPI registry since September 2011. The organization lists John Dybwad, Vp Of Finance, as its authorized official.

NPPES Registry Identity

NPI1871876789
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameEDGEWOOD SPRING CREEK BOISE, LLC
Location Address10681 MCMILLAN RDBoise, ID 83713-2628
Mailing AddressPo Box 13238Grand Forks, ND 58208 · (701) 738-2000
Organization SubpartNo
Authorized OfficialJohn DybwadVp Of Finance · (701) 757-5422
Enumeration DateSeptember 27, 2011
Last NPPES UpdateAugust 19, 2022
NPPES CertifiedAugust 19, 2022
NPI 1871876789 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 · RC1006
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.

10681 MCMILLAN RD, Boise, ID 83713

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 Boise, LLC's NPI number?

The NPI number for Edgewood Spring Creek Boise, LLC is 1871876789. It was assigned to this organization in the NPPES registry on September 27, 2011.

Where is Edgewood Spring Creek Boise, LLC located?

Edgewood Spring Creek Boise, LLC is located at 10681 Mcmillan Rd, Boise, ID 83713. The listed phone number is (208) 954-5660.

What is Edgewood Spring Creek Boise, 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 Boise, LLC was last updated on August 19, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.