Organization
SPOKANE-IDAHO FALLS LLC
Active
Parent organization
IDFALLS, LLC
Other names
IDFALLS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
IDFALLS, LLC
Authorized official
MACHELLE RAE BERGEMAN (GENERAL MANAGER)
(208) 542-6200
Entity
Organization
Contact information
Practice address
3310 VALENCIA DR, IDAHO FALLS, ID 83404-7502
(208) 542-6200
(208) 552-6139
Mailing address
3310 VALENCIA DR, IDAHO FALLS, ID 83404-7502
(208) 542-6200
(208) 552-6139
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
10/04/2022
Last updated
10/04/2022
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