Edgewood Spring Creek Eagle Island LLC
NPI 1114383577ActiveOrganization· Assisted Living Facility· Boise, ID
Assisted Living Facility in Boise, Idaho, registered in NPPES in January 2016. The authorized official on file is John Dybwad, Vp Of Finance.
Overview
| NPI | 1114383577 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 14, 2016 |
| Last updated in NPPES | Aug 19, 2022 |
| Certified by provider | Aug 19, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Assisted Living Facility Primary | 310400000X | RC1104 | ID |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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