NPI age
14 years
Enumerated 2011-10-20
● Active Type 2 · Organization
Edgewood Spring Creek Eagle, Llc
Edgewood Spring Creek Eagle, Llc is 1 of 202 assisted living facility organizations in Idaho.
Primary specialty
Assisted Living Facility
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Dybwad
Vp Of Finance
Last NPPES update
2022-08-18
Source: CMS NPPES provider record
How this organization compares
Across 202 active assisted living facility providers in Idaho.
NPI age
14 years
↑ 8 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2011 → 2022
2011-10Enumerated in NPPES
2011
2022
Where they practice
Primary practice location
653 N Eagle Rd
Eagle, ID 836166921
Mailing address
Po Box 13238
Grand Forks, ND 58208
Authorized official
John Dybwad
Vp Of Finance
📞 7017575422
Specialties
-
Assisted Living Facility PrimaryA 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.
Practice context
Single-site organization. Only one practice location on file.
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