Organization Active NPI

Swan Falls Assisted Living

  • Assisted Living Facility
  • Kuna, ID
National Provider Identifier
1104360429
Registry record updated Dec 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
RC-1131 Issued in ID
Legal business name
SWAN FALLS ASSISTED LIVING
Practice address
194 W White Way
Kuna, ID 83634-2989
Phone
(208) 922-3536
Fax
(208) 922-3538
NPI assigned
Dec 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Troy V Bell
Title
Ceo
Phone
(208) 221-0481

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X RC-1131 ID Primary

Addresses

Primary practice location

194 W White Way
Kuna, ID 83634-2989

Mailing address

194 W White Way
Kuna, ID 83634-2989
Phone (208) 922-3536

Other identifiers 1

IdentifierTypeStateIssuer
RC-1131MedicaidID

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1480896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480896000000",
    "number": "1104360429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 W WHITE WAY",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836342989",
            "telephone_number": "208-922-3536",
            "fax_number": "208-922-3538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 W WHITE WAY",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836342989",
            "telephone_number": "208-922-3536",
            "fax_number": "208-922-3538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWAN FALLS ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-05",
        "last_updated": "2016-12-05",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-221-0481"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "ID",
            "license": "RC-1131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RC-1131",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kuna, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.