Willowbrook LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

RC-845 Issued in ID

Legal business name

WILLOWBROOK LLC

Doing business as

Willowbrook Assisted Living

Practice address

1871 Julie LN
Twin Falls, ID 83301-3525

Phone

(208) 736-3727

Fax

(208) 732-6047

NPI assigned

Dec 3, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Kevin Paul Haight

Title

Administrator, Owner

Phone

(208) 736-3727

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Willowbrook Assisted Living Doing business as

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

{
    "created_epoch": "1165104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253664000000",
    "number": "1316015605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1871 JULIE LN",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013525",
            "telephone_number": "208-736-3727",
            "fax_number": "208-732-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1871 JULIE LN",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013525",
            "telephone_number": "208-736-3727",
            "fax_number": "208-732-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOWBROOK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-03",
        "last_updated": "2009-09-23",
        "status": "A",
        "authorized_official_last_name": "HAIGHT",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "ADMINISTRATOR, OWNER",
        "authorized_official_telephone_number": "208-736-3727",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "ID",
            "license": "RC-845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8074013",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willowbrook Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tiara Mae Williams, LMSW
• Troy Alan Williams, DDS MDS
• Vincent L Williams, DMD,PA
• Neelie Berlin Willis, PA-C
• Willow Creek Physical & Sports Therapy
• Erika L Willsey
• Mallory Antonetta Wilson, SUDA
• Evelyn Claire Wiltse, RD, LD
• Wings Charter Middle School, Inc.
• Kendra Wininger

• Assisted Living Facility in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Assisted Living Facility in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; 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.