Organization
CREEKSIDE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN DAVID BOWDEN (MANAGING MEMBER)
(801) 319-0071
Entity
Organization
Contact information
Practice address
222 6TH AVE W, JEROME, ID 83338-1834
(208) 373-1424
Mailing address
4423 N 1600 E, BUHL, ID 83316-5326
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
05/28/2025
Last updated
05/28/2025
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