# ICARE SUPPORTED LIVING, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083026579
- **Authorized official:** MRS. CARI RENEE GILBERT B.S.W. (OWNER/ ADMINISTRATOR/ QIDP)
- **Authorized official phone:** (208) 695-3505

## Contact information

- **Practice address:** 1903 N WINDSOR PARK AVE, MIDDLETON, ID 83644-5584
- **Practice address phone:** (208) 695-3505
- **Practice address fax:** (208) 955-4130
- **Mailing address:** 1903 N WINDSOR PARK AVE, MIDDLETON, ID 83644-5584
- **Mailing address phone:** (208) 695-3505
- **Mailing address fax:** (208) 955-4130

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | RHA-5220 | ID | Yes |

## Other

- **Enumeration date:** 06/02/2014
- **Last updated:** 06/02/2014