Organization
ASPEN CREEK CALDWELL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY TAYLOR (CFO)
(208) 863-6379
Entity
Organization
Contact information
Practice address
4119 LENITY LIVING AVE, CALDWELL, ID 83605-4988
(208) 454-1200
Mailing address
4119 LENITY LIVING AVE, CALDWELL, ID 83605-4988
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A0010160
—
ID
01
—
RC1267
IDAHO DEPARTMENT OF HEALTH & WELFARE
ID
Enumeration date
11/07/2022
Last updated
11/07/2022
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