Organization
STONEBRIDGE ASSISTED LIVING LLC
Active
Other names
Matt Gaver
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW GAVER (OWNER)
(801) 518-5230
Entity
Organization
Contact information
Practice address
356 E CLEVELAND AVE, GLENNS FERRY, ID 83623-2404
(801) 518-5230
Mailing address
1670 E 4500 N, BUHL, ID 83316-5303
(801) 518-5230
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
10/25/2021
Last updated
10/25/2021
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