East Idaho Residential Habilitation LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

EAST IDAHO RESIDENTIAL HABILITATION LLC

Practice address

550 Linden Dr
Idaho Falls, ID 83401-4149

Phone

(208) 360-8102

NPI assigned

Mar 3, 2025

Organization subpart

No

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

Authorized official

Name

Karen Faye Tornkvist

Title

Owner

Phone

(208) 360-8102

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1740960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1376340893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 LINDEN DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014149",
            "telephone_number": "208-360-8102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 LINDEN DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014149",
            "telephone_number": "208-360-8102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1061 Curlew Dr",
            "address_purpose": "LOCATION",
            "city": "Ammon",
            "state": "ID",
            "postal_code": "834064766",
            "country_code": "US",
            "telephone_number": "208-821-6360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1098 Diamond Dr",
            "address_purpose": "LOCATION",
            "city": "Ammon",
            "state": "ID",
            "postal_code": "834064928",
            "country_code": "US",
            "telephone_number": "208-821-6360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EAST IDAHO RESIDENTIAL HABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-03",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-02",
        "status": "A",
        "authorized_official_last_name": "TORNKVIST",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "FAYE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-360-8102"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; 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.