Table Rock Senior Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

TABLE ROCK SENIOR LIVING LLC

Practice address

1675 E Riverside Dr Ste 150
Eagle, ID 83616-7584

Phone

(208) 401-1400

NPI assigned

Mar 1, 2022

Organization subpart

No

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

Authorized official

Name

Amber L Tueller

Title

Secretary

Phone

(208) 207-2726

Specialties & licenses 1

Addresses

Other names 1

• Table Rock Senior Living at Barber Station Doing business as

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749600000000",
    "number": "1407502297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 E RIVERSIDE DR STE 150",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836167584",
            "telephone_number": "208-401-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 E RIVERSIDE DR STE 150",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836167584",
            "telephone_number": "208-401-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TABLE ROCK SENIOR LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-01",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-207-2726"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Table Rock Senior Living at Barber Station",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Eagle, ID
• Providers in Eagle, 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 Jun 11, 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.