Organization
REGENCY COLUMBIA VILLAGE, LLC
Active
Other names
REGENCY @ COLUMBIA VILLAGE
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG DEVORE (CFO)
(425) 392-4066
Entity
Organization
Contact information
Practice address
3521 E LAKE FOREST DR, BOISE, ID 83716-5614
(208) 344-2954
Mailing address
3521 E LAKE FOREST DR, BOISE, ID 83716-5614
(208) 344-2954
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/02/2007
Last updated
11/02/2007
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