Organization
TOP TIER CARE SUPPORTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT W REYNOLDS QIDP (ADMINISTRATOR)
(208) 919-0117
Entity
Organization
Contact information
Practice address
12273 W LEWISBURG DR, BOISE, ID 83709-8109
(208) 919-0117
Mailing address
12273 W LEWISBURG DR, BOISE, ID 83709-8109
(208) 919-0117
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A0011337
—
ID
Enumeration date
03/27/2026
Last updated
03/27/2026
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