P Praxis·MD
● Active Type 2 · Organization

Edgewood Spring Creek Soda Springs, Llc

Assisted Living Facility·Soda Springs, ID· NPI 1841575982 · Enumerated 2011 · 14 years on NPI
Edgewood Spring Creek Soda Springs, Llc is 1 of 201 assisted living facility organizations in Idaho.
NPI age
14 years
Enumerated 2011-10-20
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
2022-08-19
Source: monthly bulk 2026-05

How this organization compares

Across 201 active assisted living facility providers in Idaho.

NPI age
14 years
↑ 9 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0

NPI lifetime · 2011 → 2026

2011-10Enumerated in NPPES
2011 2026

Where they practice

Primary practice location
425 S Spring Creek Dr
Soda Springs, ID 832761628
📞 2085470257fax 2085474879
Mailing address
Po Box 13238
Grand Forks, ND 58208
📞 7017382000fax 2083506761

Authorized official

John Dybwad
Vp Of Finance
📞 7017575422

Specialties

  • Assisted Living Facility Primary
    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.
    ID license #RC-1010 taxonomy 310400000X

Practice context

Single-site organization. Only one practice location on file.

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How to verify this organization

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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