Provider Demographics
NPI:1578071270
Name:MEADOWS ASSISTED LIVING CENTER
Entity Type:Organization
Organization Name:MEADOWS ASSISTED LIVING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-756-1043
Mailing Address - Street 1:16 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:SALMON
Mailing Address - State:ID
Mailing Address - Zip Code:83467-5003
Mailing Address - Country:US
Mailing Address - Phone:208-756-1043
Mailing Address - Fax:208-756-1472
Practice Address - Street 1:16 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:SALMON
Practice Address - State:ID
Practice Address - Zip Code:83467-5003
Practice Address - Country:US
Practice Address - Phone:208-756-1043
Practice Address - Fax:208-756-1472
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JMB SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDRC-1002310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility