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Organization

ANTELOPE CREEK ASSISTED LIVING

Active
Other names
Antelope Creek Assisted Living, Antelope Creek Assisted Living
Organization subpart
No

Provider details

NPI number
Authorized official
KASEY D BORGMAN (DIRECTOR OF CORP COMPLIANCE)
(208) 245-4576
Entity
Organization

Contact information

Practice address
3668 W. 3700 N., DARLINGTON, ID 83255-0909
(208) 588-2700
(208) 588-2701
Mailing address
820 ELM DR, ST MARIES, ID 83861-2119
(208) 245-4576
(208) 245-2138

Taxonomy

Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
3104A0630X
Assisted Living Facility (Behavioral Disturbances)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
805729800
ID
Enumeration date
11/29/2006
Last updated
12/24/2025
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