Provider Demographics
NPI:1790582666
Name:CTM ASSISTED LIVING
Entity type:Organization
Organization Name:CTM ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-794-4990
Mailing Address - Street 1:7100 S VALLEY HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-7093
Mailing Address - Country:US
Mailing Address - Phone:208-794-4990
Mailing Address - Fax:
Practice Address - Street 1:9 S MIDLAND BLVD
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-2420
Practice Address - Country:US
Practice Address - Phone:208-794-4990
Practice Address - Fax:208-278-2282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health