Organization
WOODLAND ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN CRABTREE (OWNER)
(208) 731-0862
Entity
Organization
Contact information
Practice address
19937C HIGHWAY 30, BUHL, ID 83316-5511
(208) 731-4222
Mailing address
PO BOX 547, BUHL, ID 83316-0547
(208) 731-4222
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AOOO2434
—
ID
Enumeration date
03/25/2022
Last updated
03/25/2022
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