Organization
JUBILATION HOUSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK BROWNING (PARTNER)
(801) 836-6275
Entity
Organization
Contact information
Practice address
165 CONSTELLATIONS RD, IDAHO FALLS, ID 83402-4988
(801) 836-6275
Mailing address
3144 TIPPERARY LN, IDAHO FALLS, ID 83404-7323
(801) 836-6275
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
RC-1125
ID
3104A0625X
Assisted Living Facility (Mental Illness)
RC-1125
ID
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
RC-1125
ID
Other
Enumeration date
11/02/2016
Last updated
11/02/2016
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