Table Rock Senior Living LLC

NPI #1407502297 in Eagle, Idaho

Provider Information

NPI Number: 1407502297
Entity Type: Organization
Organization Name: Table Rock Senior Living LLC
Primary Specialty: Assisted Living Facility
Enumeration Date: Mar 1, 2022
Last Updated: Jun 11, 2025

Practice Location

Address: 1675 E RIVERSIDE DR STE 150
City: Eagle
State: Idaho
ZIP Code: 83616-7584
Phone: (208) 401-1400

Authorized Official

Name: AMBER L TUELLER
Title: SECRETARY
Phone: (208) 207-2726

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Assisted Living Facility	310400000X	Primary

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