Organization
WILLOWBROOK LLC
Active
Other names
Willowbrook Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN PAUL HAIGHT (ADMINISTRATOR, OWNER)
(208) 736-3727
Entity
Organization
Contact information
Practice address
1871 JULIE LN, TWIN FALLS, ID 83301-3525
(208) 736-3727
(208) 732-6047
Mailing address
1871 JULIE LN, TWIN FALLS, ID 83301-3525
(208) 736-3727
(208) 732-6047
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
RC-845
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8074013
—
ID
Enumeration date
12/03/2006
Last updated
09/23/2009
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