Provider Demographics
NPI:1235901018
Name:SILVERTON OF CASCADIA, LLC
Entity Type:Organization
Organization Name:SILVERTON OF CASCADIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-401-9618
Mailing Address - Street 1:2205 E RIVERSIDE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-7621
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:405 W 7TH STREET
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:ID
Practice Address - Zip Code:83867
Practice Address - Country:US
Practice Address - Phone:208-556-1147
Practice Address - Fax:208-753-6411
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SILVERTON OF CASCADIA, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility