Organization
10250 W SMOKE RANCH DRIVE OPCO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATT GAGNON GAGNON (DIRECTOR OF BUSINESS OPTIMIZATION)
(207) 540-3810
Entity
Organization
Contact information
Practice address
10250 W SMOKE RANCH DR, BOISE, ID 83709-1467
(208) 322-2900
Mailing address
10250 W SMOKE RANCH DR, BOISE, ID 83709-1467
(207) 540-3810
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
311500000X
Alzheimer Center (Dementia Center)
—
—
Other
Enumeration date
05/01/2026
Last updated
05/01/2026
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