Organization
MOSCOW OF OLYMPUS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER BAIRD (ASSISTANT GENERAL COUNSEL)
(208) 401-9600
Entity
Organization
Contact information
Practice address
640 N EISENHOWER ST, MOSCOW, ID 83843-9588
(208) 401-9600
(208) 314-0639
Mailing address
2205 E RIVERSIDE DR STE 100, EAGLE, ID 83616-7621
(208) 401-9600
(208) 314-0639
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
10/25/2022
Last updated
02/23/2023
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