NPI: 1003191149 · EAGLE, ID 83616 · Assisted Living Facility · NPI assigned 10/20/2011
| Authorized Official | DYBWAD, JOHN (VP OF FINANCE) |
| NPI Enumeration Date | 10/20/2011 |
Other providers sharing the same authorized official: DYBWAD, JOHN
| Provider | City | State | Total Paid |
|---|---|---|---|
| EDGEWOOD FRUITLAND SENIOR LIVING LLC | FRUITLAND | ID | $2.55M |
| EDGEWOOD SPRING CREEK OVERLAND, LLC | BOISE | ID | $2.22M |
| EDGEWOOD CASTLE HILLS LLC | BOISE | ID | $2.06M |
| EDGEWOOD SPRING CREEK BOISE, LLC | BOISE | ID | $1.57M |
| EDGEWOOD SPRING CREEK EAGLE ISLAND LLC | BOISE | ID | $1.28M |
| EDGEWOOD SPRING CREEK AMERICAN FALLS, LLC | AMERICAN FALLS | ID | $1.03M |
| EDGEWOOD RAPID CITY LLC | RAPID CITY | SD | $639K |
| EDGEWOOD SPRING CREEK USTICK, LLC | MERIDIAN | ID | $502K |
| EDGEWOOD PLANTATION PLACE LLC | BOISE | ID | $201K |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 15 | $13K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| S5140 | Foster care, adult; per diem | 15 | 12 | $13K |