Regency Columbia Village, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

REGENCY COLUMBIA VILLAGE, LLC

Doing business as

REGENCY @ COLUMBIA VILLAGE

Practice address

3521 E Lake Forest Dr
Boise, ID 83716-5614

Phone

(208) 344-2954

NPI assigned

Nov 2, 2007

Organization subpart

No

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

Authorized official

Name

Doug Devore

Title

Cfo

Phone

(425) 392-4066

Specialties & licenses 1

Addresses

Other names 1

• REGENCY @ COLUMBIA VILLAGE Doing business as

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193961600000",
    "number": "1922287242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3521 E LAKE FOREST DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837165614",
            "telephone_number": "208-344-2954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3521 E LAKE FOREST DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837165614",
            "telephone_number": "208-344-2954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENCY COLUMBIA VILLAGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2007-11-02",
        "status": "A",
        "authorized_official_last_name": "DEVORE",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "425-392-4066"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REGENCY @ COLUMBIA VILLAGE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adrianna Regalado, LMT
• Shawna Michelle Reger, RN MSN
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• Jackie Lynn Rehnstrom, LPN
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• Assisted Living Facility in Boise, ID
• Providers in Boise, 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 Nov 2, 2007; 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.