Edgewood Spring Creek Ustick, LLC

NPI #1225313737 in Meridian, Idaho

Provider Information

NPI Number
1225313737
Entity Type
Organization
Organization Name
Edgewood Spring Creek Ustick, LLC
Primary Specialty
Assisted Living Facility
Enumeration Date
Oct 15, 2011
Last Updated
Aug 19, 2022

Practice Location

Address
3165 MERIDIAN RD
State
Idaho
ZIP Code
83646
Phone
(208) 287-2064

Authorized Official

Name
JOHN DYBWAD
Title
VP OF FINANCE
Phone
(701) 757-5422

Specialties & Taxonomy Codes

Specialty
Assisted Living Facility

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