OrganizationActive
Edgewood Plantation Place LLC
NPI 1023305497 · Assisted Living Facility · Boise, ID
Edgewood Plantation Place LLC is a Assisted Living Facility organization in Boise, ID (NPI 1023305497).
Provider details
- NPI number
- 1023305497
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- John Dybwad, Vp of Finance(701) 757-5422
- License
- 83703 (ID)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(81/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3921 Kessinger Ln
Boise, ID 83703-3003
Phone: (208) 853-7300
Fax: (208) 853-9328
Street-level locationGet directions
Mailing address
Po Box 13238
Grand Forks, ND 58208
Registry dates
- Enumerated
- 2011-07-06
- Last updated
- 2022-08-18
- Certified
- 2022-08-18
Frequently asked questions
- What is Edgewood Plantation Place LLC's NPI number?
- Edgewood Plantation Place LLC's National Provider Identifier (NPI) is 1023305497, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Edgewood Plantation Place LLC?
- Edgewood Plantation Place LLC is classified in the NPPES registry as Assisted Living Facility (Nursing & Custodial Care Facilities).
- Where is Edgewood Plantation Place LLC located?
- Edgewood Plantation Place LLC's practice location on file with NPPES is 3921 Kessinger Ln, Boise, ID 83703-3003.
- What is Edgewood Plantation Place LLC's phone number?
- The practice phone number listed in the NPPES registry for Edgewood Plantation Place LLC is (208) 853-7300.
- Who is the authorized official for Edgewood Plantation Place LLC?
- The authorized official listed on Edgewood Plantation Place LLC's NPPES record is John Dybwad, Vp of Finance. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Edgewood Plantation Place LLC's NPI active?
- Yes — Edgewood Plantation Place LLC's NPI (1023305497) is active in the NPPES registry as of the last update on 2022-08-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.