Spring Creek Idaho, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SPRING CREEK IDAHO, LLC

Practice address

175 E Calderwood Dr
Meridian, ID 83642-7482

Phone

(208) 884-6199

Fax

(208) 639-3419

NPI assigned

Mar 8, 2007

Organization subpart

No

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

Authorized official

Name

Virginia Thornley

Title

Bookkeeper

Phone

(208) 855-5005

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Spring Creek Manor Other name

Locations

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376674622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 E CALDERWOOD DR # E",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427500",
            "telephone_number": "208-855-5005",
            "fax_number": "208-855-5034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E CALDERWOOD DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427482",
            "telephone_number": "208-884-6199",
            "fax_number": "208-639-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING CREEK IDAHO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THORNLEY",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_title_or_position": "BOOKKEEPER",
        "authorized_official_telephone_number": "208-855-5005"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8059942000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spring Creek Manor",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Assisted Living Facility in Meridian, ID
• Providers in Meridian, 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 Aug 22, 2020; 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.