Organization
LIVING SPRING RESIDENTIAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARCUS CHARLES FOWLER (OWNER)
(208) 743-2685
Entity
Organization
Contact information
Practice address
1050 HEMLOCK DR, LEWISTON, ID 83501-5434
(208) 743-2685
Mailing address
1050 HEMLOCK DR, LEWISTON, ID 83501-5434
(208) 743-2685
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
RC-957
ID
Other
Enumeration date
01/01/2009
Last updated
01/01/2009
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